PATIENT CARE TRANSITION
Planning for our patients during times of transitions (for example: hospital to home, home to rehabilitation facility) involves collaboration with a number of healthcare professionals. Please address the following questions: PATIENT CARE TRANSITION
How does your facility promote interprofessional collaboration during times of patient transitions?
What is the role of the nurse in patient transitions?
What gaps can you identify in this process related to quality of care? (If you are not currently in practice, please use a previous role or clinical experience in your answers.)
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Patient Care Transitions from One Setting to Another and the Role of Nurses in the Process
Transition of care is the process that occurs when a patient changes the location of his or her care. This could be from the hospital to the patient’s home (a discharge), from the hospital to a rehabilitation facility, from the hospital to a nursing home or aged care residence, or grom one unit to another in the same hospital (Brady, 2016).
My facility has promoted interprofessional collaboration at times of patient transitions by first and foremost recognising and appreciating the immense significance of transition on the health outcomes of discharged patients. To this end, it has put in place policies that encourage and promote synchronous communication (preferably face to face) between the doctor, the nurse, the patient, and the patient’s family (Pinelli et al., 2015). Also, the facility has come up with particular standard operating procedures or SOPs that guide yhis policy on discharge/ transition. The whole process is clearly laid down and all the stages must be followed by the doctors and the nurses, who must append their initials at the end for accountability. PATIENT CARE TRANSITION
The nurse is arguably the most significant member of the healthcare team in the whole process of transition. Amongst others, her roles in transition of care include educating the patient on his diagnosis, his medication, and how to take care of himself at home. The others are practising teamwork and planning for follow up (Brafy, 2016).
The most important gap identified with regard to quality of care in the process of patient transition is haste. Because of the ever-present shortage of healthcare personnel together with other factors, the nurse handling transition is more often than not in a hurry. This inevitably leads to inadvertent omissions and misrepresentations which may at times prove very costly.
References
Brady, J. (2016). Making care transitions safer: The pivotal role of nurses. Retrieved 30 September 2019 from https://www.ahrq.gov/news/blog/ahrqviews/pivotal-role-nurses.html
Pinelli, V.A., Papp, K.K., & Gonzalo,J.D. (2015). Interprofessional communication patterns during patient discharges: A social network analysis. Journal of General Internal Medicine, 30(9), 1299-1306. Doi: 10.1007/s11606-015-3415-2
PATIENT CARE TRANSITION
