Continuity of Care during Care Transition: Nurses’ Experiences and Challenges

Else Cathrine Rustad,Elin Dysvik,Berit Seiger Cronfalk,Bodil Furnes

doi:10.4236/ojn.2017.72023

Abstract

The aim of this study was to gain increased knowledge about nurses’ experiences of care transition of older patients from hospital to municipal health care, based on two research questions: How is nurses’ experience continuity during care transition of older patients from hospital to municipal health care? How would nurses describe an optimal care transition? Nurses have a pivotal role during care transitions of older patients. More knowledge about their experiences is necessary to develop favorable improvements for this important period in the older patient’s treatment and care. The study has a qualitative explorative design with follow-up focus group interviews. Nurses (N = 30) working in hospital (n = 16) and municipal (n = 14) health care were organized in five mixed focus groups during the period October-January 2014/2015. The focus groups met twice, answering the research questions following a previously circulated semi-structured interview guide. The interview analysis was inspired by content analysis. The analysis resulted in the themes “Administrative demands challenge terms for collaboration” and “Essentials for nursing determine optimal care transitions for older patients”. Administrative demands may prevent nurses’ professional dialogue and collaboration across health care levels. Older patients’ best interests should be ensured through a collaborative relationship between hospital and municipal nurses, to form continuous care across health care levels. Clinical practice should be aware of essentials for nursing, which could influence and facilitate a more individualized and continuous transition for older patients.

Highlights

A successful care transition from hospital to municipal health care is understood as the coordination of multiple factors to ensure continuity of the patient’s treatment and care [1]
Analysis of data from meeting 1 (A1-E1) resulted in the theme “Administrative demands challenge terms of collaboration”, interpreted from two categories; “Care transition rests on extensive routines” and “Professional collaboration is prevented by external conditions” (Table 2)
The focus groups gave the opportunity to discuss the range of hospital care: B1: - (Hospital nurse) Usually, we end our care initiatives when the patient is discharged

Summary

Introduction

A successful care transition from hospital to municipal health care is understood as the coordination of multiple factors to ensure continuity of the patient’s treatment and care [1]. By using incentives to skew treatment and care to municipal level, responsibilities and demands for nurses involved in care transitions of older patients are altered [5]. Both hospital and municipal nurses play a key role during this important period of treatment and care, and they have first hand contact with the older patients and their of kin [6] [7]. Norway has organized health care services in a New Public Management model, with the intention of making health care more efficient [8] In this model the patient requests health care services from municipal health care through a purchaser-provider model.

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Discussion

Conclusion