Friday, 28 October 2016

Nursing home resident transfer to emergency care

Roger Watson, Editor

The aim of this study was: '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.'  The study is from Sweden by Kirsebom et al. (2106) titled: 'Transfer of nursing home residents to emergency departments: organizational differences between nursing homes with high vs. low transfer rates' and published in Nursing Open.

Five nursing homes were studied and, as explained by the authors: 'All of the nursing homes’ websites, where the facilities are described, were read to establish whether they expressed some sort of care philosophy or theory.'  Other aspects of care were also studied such as nurse training in care of older people with dementia and years of caring for people with dementia. Nurisng homes were also classified as private for-profit or public. There was an association between being a high transfer to emergency care home and being private for-profit. In the low transfer homes more nurses had training in caring for older people with dementia and had worked longer with people with dementia. 

The authors concluded: 'Taken together, the present findings indicate that organizational factors could be related to differences in transfer rates between nursing homes. Our data reveal that nursing homes identified with the highest transfer rates to ED (emergency departments) were run by for-profit providers to a higher extent and had updated ACPs (advanced care plans) for their residents to a lower extent than did nursing homes with the lowest transfer rates. Further, RNs’ level of competence may be related to transfer rates. Improved use of ACPs in nursing homes needs to be in focus if the care provided is to conform to the wishes of residents and their families. Better adherence to ACPs could enhance the care and outcome for residents, thereby possibly reducing transfers to the ED. This needs to be further explored.'


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