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  • 1.
    Kirsebom, Marie
    et al.
    Uppsala University.
    Hedström, Mariann
    Uppsala University.
    Pöder, Ulrika
    Uppsala University.
    Wadensten, Barbro
    Uppsala University.
    Transfer of nursing home residents to emergency departments: organizational differences between nursing homes with high vs. low transfer rates2017Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 4, nr 1, s. 41-48Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To explore possible factors in the organization of nursing homes that could be related to differences in the rate of transfer of residents from nursing homes to emergency department.

    Design: Explorative.

    Method: In a single municipality, qualitative and quantitative data were collected from documents and through semi-structured interviews with 11 RNs from five nursing homes identified as having the highest vs. six identified as having the lowest transfer rates to emergency department. Data were analysed by non-parametric tests and basic content analysis.

    Results: All nursing homes in the highest transfer rate group and one in the lowest transfer rate group were run by private for-profit providers. Compared with the low group, the high group had fewer updated advance care plans and the RNs interviewed had less work experience in care of older people and less training in care of persons with dementia. There was no difference in nursing home size or staff/resident ratio. The RNs described similar possibilities to provide palliative care, medical equipment and perceived medical support from GPs.

  • 2.
    Kirsebom, Marie
    et al.
    Uppsala University.
    Wadensten, Barbro
    Uppsala University.
    Hedström, Mariann
    Uppsala University.
    Communication and coordination during transition of older persons between nursing homes and hospital still in need of improvement2013Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, nr 4, s. 886-895Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim:

    To investigate registered hospital and nursing home nurses' experiencesof coordination and communication within and between care settings when olderpersons are transferred from nursing homes to hospital and vice versa.

    Background:

    It has previously been reported that transfers to hospital from nursing homes and discharge of patients from hospital are surrounded by communication difficulties. However, studies focusing on both hospital and nursing home registered nurses' experiences of communication and coordination within and between nursing homes and hospitals are uncommon.

    Design:

    A descriptive study design with a qualitative approach was used.

    Methods:

    In 2008, three focus group discussions were conducted with registered nurses from hospitals and nursing homes (n=20). Data were analysed using content analysis.

    Results:

    Nursing home registered nurses found it difficult to decide whether the older person should be referred to hospital from the nursing home. Hospitalregistered nurses reported often trying to stop premature discharges or having to carry out the discharge although it had not been fully prepared. Both hospital and nursinghome registered nurses suggested increased collaboration to understand each other's work situation better.

    Conclusion:

    Communication and coordination among hospital andnursing home registered nurses need to be furthered improved. Registered nurses'coordination and planning in the nursing home are extremely important to future elder care. We recommend that the medical care plan be regularly updated and meticulously followed, the aim being to reduce the risk of inappropriate medical treatment and nursingcare and unnecessary transfer and admission to hospital.

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