Discharge Teaching, Readiness for Discharge, and Post-discharge Outcomes in Parents of Hospitalized Children. J Pediatr Nurs 2017;34:58-64
Date
01/15/2017Pubmed ID
28087088DOI
10.1016/j.pedn.2016.12.021Scopus ID
2-s2.0-85009494280 (requires institutional sign-in at Scopus site) 128 CitationsAbstract
PURPOSE: This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).
DESIGN/METHODS: In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits).
RESULTS: Parent-reported quality of discharge teaching delivery (the way nurses teach), but not the amount of content, was positively associated with parent perception (B=0.54) and nurse assessment (B=0.16) of discharge readiness. Parent-reported discharge readiness was negatively associated with post-discharge coping difficulty (B=-0.52). Nurse assessment of discharge readiness was negatively associated with readmission; a one point increase in readiness (on a 10 point scale) decreased the likelihood of readmission by 52%.
CONCLUSION: There is a sequential effect of quality of discharge teaching delivery on parent discharge readiness, which is associated with parent coping difficulty and child readmission.
PRACTICE IMPLICATIONS: Efforts to improve discharge outcomes should include strategies to build nurse teaching skills for high-quality delivery of discharge teaching. In addition, routine nurse assessment of discharge readiness can be used to identify children at risk for readmission and trigger anticipatory interventions.
Author List
Weiss ME, Sawin KJ, Gralton K, Johnson N, Klingbeil C, Lerret S, Malin S, Yakusheva O, Schiffman RAuthors
Norah Johnson PhD Assistant Professor in the College ofnursing department at Marquette UniversityStacee Lerret PhD Professor Hybrid in the Pediatrics department at Medical College of Wisconsin
Rachel Schiffman BS,MS,PhD Associate Dean for Research in the College of Nursing department at University of Wisconsin - Milwaukee
Marianne Weiss DNSc Associate Professor in the College of Nursing department at Marquette University
MESH terms used to index this publication - Major topics in bold
Adaptation, PsychologicalChild
Child, Hospitalized
Child, Preschool
Continuity of Patient Care
Female
Humans
Longitudinal Studies
Male
Nurse's Role
Parents
Patient Discharge
Patient Readmission
Pediatric Nursing
Pilot Projects
Quality Control
Risk Assessment
United States
