Abstract
BackgroundA lack of standardisation of documentation accompanying older people when transferring from residential to acute care is common and this may result in gaps in information and in care for older people. In Ireland, this lack of standardisation prompted the development of an evidence based national transfer document.ObjectivesTo pilot a new national transfer document for use when transferring older people from residential to acute care and obtain the perceptions of its use from staff in residential and acute care settings.MethodsThis was a pre‐ and post‐study design using purposive sampling following the STROBE guidelines. The pilot was conducted in 26 sites providing residential care and three university hospitals providing acute care. Pre‐pilot questionnaires focused on current documentation and were distributed to staff in residential care (n = 875). A pilot of the new paper‐based transfer document was then conducted over three months and post‐pilot questionnaires distributed to staff from both residential and acute care settings (n = 1085). The findings of the pilot study were discussed with multidisciplinary expert advisory and stakeholder groups who recommended some revisions. This consensus informed the development of the final design of the new revised transfer document.ResultsPre‐pilot: 23% response rate; 83% (n = 168) participants agreed/strongly agreed that existing documentation was straightforward to complete but could be more person‐centred. Post‐pilot: 11% response rate; 75% (n = 93) of participants agreed/strongly agreed that the new transfer document promoted person‐centred care but recommended revisions to the new document regarding layout and time to complete.ConclusionsThis study highlighted some of the challenges of providing safe, effective and relevant transfer information that is feasible and usable in everyday practice.Implications for practiceStandardisation and being person‐centred are important determining factors in the provision of relevant up to date information on the resident being transferred.
Highlights
Older people account for a high proportion of transfers to emergency departments and admissions to acute hospitals (Barbadoro et al, 2015; Franchi et al, 2017)
Older people are the largest group presenting with illness to Irish acute services, accounting for one-fifth of all emergency department admissions (Department of Health, 2018)
This paper reports on the piloting of the document and presents the findings of the pre-study and post-study
Summary
Older people account for a high proportion of transfers to emergency departments and admissions to acute hospitals (Barbadoro et al, 2015; Franchi et al, 2017). A pilot of the new paper-based transfer document was conducted over three months and post-pilot questionnaires distributed to staff from both residential and acute care settings (n = 1085). Informed by evidence from a literature review, a qualitative study with stakeholders (O'Reilly et al, 2019), consultation with a multidisciplinary expert advisory group (advisory group) and an expert in person-centred care, the components and format of a transfer document were identified and developed. It consisted of two sections: one contained biographical and essential medical information, and the other profiled the person's personal preferences and usual health status. As the proposed transfer document would be used nationally, it was agreed to pilot it across several institutions to identify any areas that needed revision before it was put into general use
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