Liaison Nurses Research Articles

An Audit of the Fifth Irish Hip Fracture Standard in patients >=70 years following hip fracture

Abstract Background Hip fractures are a significant cause of morbidity and mortality in older adults. Bone health assessment is key in the reduction of future fracture risk. The aim of our study was to examine the adherence to the fifth Irish Hip Fracture Standard in patients >=70 years presenting to Letterkenny University Hospital (LUH) with a hip fracture and to examine the number of patients who were commenced on bone protection. Methods We included patients >=70 years who were admitted under the Orthopaedic service following a hip fracture between January and June 2023 in LUH and were identified the database maintained by the using Fracture Liaison Nurse. Data collected included age, month in which hip fracture occurred, patient resident in Ireland, patient alive/deceased, patient on bone protection prior to fracture, patient commenced on bone protection or patient declined treatment. Data was recorded in a Microsoft excel spreadsheet and was analysed by the clinical audit facilitator. We measured our data against the British Geriatric Society guideline on the use of IV zoledronate following hip fracture. Results 76 patients were admitted to LUH with a hip fracture >=70 years between January and June 2023. 100% of patients were reviewed by the fracture liaison service and following this it was recommended that 46 patients (60%) be commenced on bone protection. A letter was sent to each patient’s General Practitioner outlining the recommendation for bone protection. On follow up only 7/46 (15.2%) had been started on treatment. Conclusion The fracture liaison service is appropriately identifying patients who require treatment, despite this, patients are not starting the necessary bone protection in the community. This has prompted our service to establish an IV zoledronate clinic for patients following hip fracture and to generate a plan for ongoing treatment of this patient cohort.

A Parallel-Group, Randomized Trial Examining Impact of Colposcopy Results Delivery by a Nurse Liaison on Patient-Reported Outcomes and Adherence

ObjectivesCervical cancer is on the rise in Canada. Addressing patient anxiety and improving patient understanding of colposcopy and results may improve adherence. This randomized controlled trial examined the impact of colposcopy results delivery by a Nurse Liaison versus the referring primary care provider (PCP) on patient anxiety, and secondary outcomes including patient satisfaction, knowledge of diagnosis, and 9-month adherence to follow-up. MethodsPatients ≥18 years old presenting for initial appointment at the study colposcopy clinic were randomized 1:1 to an intervention group (Nurse Liaison) versus a control group (PCP). After receiving colposcopy results, participants completed online measures of anxiety (State-Trait Anxiety Inventory), health care satisfaction scales (Patient Satisfaction Questionnaire-18, Health Anxiety Inventory, Visit-Specific Satisfaction Questionnaire-9), self-reported colposcopy diagnosis, and demographics. Chart review at 9 months assessed adherence to recommended colposcopy follow-up. Groups were compared on continuous and categorical variables, controlling for diagnosis severity and trait anxiety. ResultsThe intervention group had significantly lower state anxiety with State-Trait Anxiety Inventory-state mean scores of 37.3 versus 40.7 in controls (P = 0.03). Intervention group participants were more likely to correctly report their diagnosis (84% vs. 66.3%, P = 0.003). Questionnaire responders were more likely to be in the intervention group and had a higher proportion of cervical intraepithelial neoplasia 2+ pathology. There were no differences in demographics, patient satisfaction, or adherence to follow-up between groups. ConclusionsDirect delivery of colposcopy results by a trained Nurse Liaison was associated with decreased patient anxiety around colposcopy results, and increased patient knowledge regarding diagnosis. This model may be considered to improve patient-centred care.

Consensus and controversies on post-acute care decision making and referral to geriatric rehabilitation: A national survey

BackgroundTransitioning older hospital patients to the appropriate type of post-acute care has become an urgent clinical issue within the context of changing demographics and limited duration of hospital stay. ObjectiveConsensus on assessments that guide post-acute care decision making would benefit potential patients and support cooperation between settings. DesignA national web-based questionnaire focusing on professional contributions, patient involvement and the use of triage items and measures. ParticipantsHospital and geriatric rehabilitation professionals in the Netherlands participated as respondent groups, representing ‘sending’ and ‘receiving’ professionals. MethodsA comprehensive questionnaire was used with open, multiple choice and closed questions, exploring in detail how assessment of hospital patients in need of a post-acute care decision was performed. Descriptive statistics were applied together with deductive coding of qualitative data. ResultsA total of 104 hospital liaison nurses (66.7 %) and 52 GR professionals (33.3 %) participated. Respondents were reasonably satisfied with the current triage practice. Hospital liaison nurses valued their operational responsibility for triage. Geriatric rehabilitation professionals wanted active involvement in decision making and deemed hospital paramedic expertise sub-optimally applied. ‘Too little involvement’ of patients and families was felt by 50.0 % of the GR respondents versus 15.5 % of hospital respondents. The importance of half (47.8 %) of the triage items was rated differently between respondent groups. When discussing complex cases between sending and receiving professionals, views were felt as complementary. ConclusionsBoth sending and receiving professionals expressed moderate satisfaction with post-acute care decision making, whereas their views on triage assessments differed according to setting and role. The patients’ voice may be insufficiently heard in triage decisions. Shared expertise and a consensual approach can develop when triage consultation is facilitated by both hospitals and PAC facilities. This study offers ingredients to reach a multi-professional view on post-acute care decision making and referral to geriatric rehabilitation.

Enhancing hemodynamic stability: the role of liaison nurses in patient transfers to angiography

IntroductionAngiography is associated with anxiety, stress, and changes in patients’ vital signs. The role of the liaison nurse is to bridge gaps and solve problems between departments, thereby preventing the occurrence of undesired complications during patient transfers. Proper preparation of patients by the liaison nurse may lead to an improvement in the hemodynamic status of patients. The present study was conducted to investigate the effect of liaison nurse on hemodynamic status during transfer process to angiography.MethodThis randomized controlled trial was conducted from December 2019 to March 2020 on 62 patients who were candidates for elective angiography at Imam Reza Hospital in Mashhad. Participants were selected using a convenience sampling method and then randomly assigned to either the control or intervention group using a lottery system. In the intervention group, patients benefited from the presence of a liaison nurse from the moment the transfer order was issued by the doctor. Tools used included a demographic information questionnaire and a hemodynamic signs checklist. Data were analyzed using SPSS 25 with independent T-tests, paired T-tests, Wilcoxon, Mann-Whitney test, chi-squared, and Fisher’s exact test.ResultFollowing the intervention, the mean systolic blood pressure, heart rate, and respiratory rate in the intervention group were found to be significantly lower than those in the control group (p < 0.05). In contrast, the mean body temperature, diastolic blood pressure and the percentage of arterial blood oxygen saturation did not exhibit a statistically significant difference between the two groups (p > 0.05).ConclusionThe liaison nurse role emerges as a valuable strategy for enhancing patients’ hemodynamic stability, and its implementation can have a positive impact on patient outcomes in hospital settings.

Specialist intellectual disability liaison nurses in general hospitals in England: cohort study using a large mortality dataset

ObjectiveIntellectual disability liaison nurses in general hospitals could enhance access to high-quality, adapted healthcare and improve outcomes. We aimed to explore associations between the input of intellectual disability liaison nurses...

Bridging the Gap Between the Pediatric Surgical Liaison Nurse and the Operating Room Nurse During Critical Events

Bridging the Gap Between the Pediatric Surgical Liaison Nurse and the Operating Room Nurse During Critical Events

Holding Patients and Loved Ones Through the Surgical Journey: The Implementation of a Surgical Nurse Liaison Program

Holding Patients and Loved Ones Through the Surgical Journey: The Implementation of a Surgical Nurse Liaison Program

Cardiac Liaison Nurses Play a Key Role in the Rapid Access Chest Pain Clinic at Liverpool Hospital

Cardiac Liaison Nurses Play a Key Role in the Rapid Access Chest Pain Clinic at Liverpool Hospital

The current state of intensive care unit discharge practices - Results of an international survey study.

Increasing pressure on limited intensive care capacities often requires a subjective assessment of a patient's discharge readiness in the absence of established Admission, Discharge, and Transfer (ADT) guidelines. To avoid suboptimal care transitions, it is important to define clear guidelines for the admission and discharge of intensive care patients and to optimize transfer processes between the intensive care unit (ICU) and lower care levels. To achieve these goals, structured insights into usual ICU discharge and transfer practices are essential. This study aimed to generate these insights by focusing on involved stakeholders, established processes, discharge criteria and tools, relevant performance metrics, and current barriers to a timely and safe discharge. In 2022, a structured, web-based, anonymous cross-sectional survey was conducted, aimed at practicing ICU physicians, nurses, and bed coordinators. The survey consisted of 29 questions (open, closed, multiple choice, and scales) that were divided into thematic blocks. The study was supported by several national and international societies for intensive care medicine and nursing. A total of 219 participants from 40 countries (105 from Germany) participated in the survey. An overload of acute care resources with ~90% capacity utilization in the ICU and the general ward (GW) leads to not only premature but also delayed patient transfers due to a lack of available ward and intermediate care (IMC) beds. After multidisciplinary rounds within the intensive care team, the ICU clinician on duty usually makes the final transfer decision, while one-third of the panel coordinates discharge decisions across departmental boundaries. By the end of the COVID-19 pandemic, half of the hospitals had implemented ADT policies. Among these hospitals, nearly one-third of the hospitals had specific transfer criteria established, consisting primarily of vital signs and laboratory data, patient status and autonomy, and organization-specific criteria. Liaison nurses were less common but were ranked right after the required IMC capacities to bridge the care gap between the ICU and normal wards. In this study, 80% of the participants suggested that transfer planning would be easier if there was good transparency regarding the capacity utilization of lower care levels, a standardized transfer process, and improved interdisciplinary communication. To improve care transitions, transfer processes should be managed proactively across departments, and efforts should be made to identify and address care gaps.

Construction of Training Curriculum System for Venous Thromboembolism (VTE) Liaison Nurses

Objective To construct a training curriculum system for venous thromboembolism (VTE) liaison nurses and provide a basis for corresponding clinical training, evaluation and certification. Methods Analyzed the training needs of VTE liaison nurses. Conducted two rounds of Delphi surveys with 27 experts from Hubei, Sichuan, Guizhou, Guangxi and Guangdong provinces in China. Determined the weights of indicators at all levels using the Analytic Hierarchy Process (AHP) and equal weighting method. Results The age of the participants ranged from 38~59 (46.63±5.343), and the years of working ranged from 12~42 (25.48±7.439). 27 and 26 valid questionnaires were collected respectively from the first and second rounds of the surveys. The effective response rates of the two-round Delphi survey were 90.0% and 96.3%, respectively, and the experts’ authoritative coefficients were 0.884 and 0.906, respectively, and Kendall’s coefficient of concordance of experts’ opinions were 0.261 and 0.276, respectively (P &amp;lt;0.01). A training system with 5 first-level indicators and 26 second-level indicators was finally formed after two rounds of Delphi surveys. Conclusions The training system for VTE liaison nurses constructed in this study is highly scientific and practical, which can provide a basis for the training assessment and ability evaluation of VTE liaison nurses, and also provide a reference for VTE prophylaxis, treatment and nursing.

Implementation of the Guidelines on the Voluntary Interruption of Pregnancy

The Diploma in Gender Equity of the Hospital Interzonal General de Agudos Prof. Dr. Ramón Carrillo seeks to approach health from a feminist and transfeminist perspective, especially in relation to National Law No. 25929, which guarantees the right to the Voluntary Interruption of Pregnancy (VTP). The hospital management faced challenges such as the conscientious objection of some obstetrics professionals. To overcome these obstacles, several actions were proposed, including training professionals in gender equity, expanding care services and improving communication with the community. An interdisciplinary Nurse Liaison team was established to facilitate access to abortion care and a registry system was implemented to monitor outcomes. These measures are expected to reduce barriers to access to sexual and reproductive health, empowering women and pregnant women to make informed decisions about their health. This intersectoral approach and specialized training in gender equity aims to close access gaps and improve the quality of care

Mapping clinical interactions in an Australian tertiary hospital emergency department for patients presenting with risk of suicide or self-harm: Network modeling from observational data.

Reliable assessment of suicide and self-harm risk in emergency medicine is critical for effective intervention and treatment of patients affected by mental health disorders. Teams of clinicians face the challenge of rapidly integrating medical history, wide-ranging psychosocial factors, and real-time patient observations to inform diagnosis, treatment, and referral decisions. Patient outcomes therefore depend on the reliable flow of information through networks of clinical staff and information systems. This study aimed to develop a quantitative data-driven research framework for the analysis of information flow in emergency healthcare settings to evaluate clinical practice and operational models for emergency psychiatric care. We deployed 2 observers in a tertiary hospital emergency department during 2018 for a total of 118.5 h to record clinical interactions along patient trajectories for presentations with risk of self-harm or suicide (n = 272 interactions for n = 43 patient trajectories). The study population was reflective of a naturalistic sample of patients presenting to a tertiary emergency department in a metropolitan Australian city. Using the observational data, we constructed a clinical interaction network to model the flow of clinical information at a systems level. Community detection via modularity maximization revealed communities in the network closely aligned with the underlying clinical team structure. The Psychiatric Liaison Nurse (PLN) was identified as the most important agent in the network as quantified by node degree, closeness centrality, and betweenness centrality. Betweenness centrality of the PLN was significantly higher than expected by chance (>95th percentile compared with randomly shuffled networks) and removing the PLN from the network reduced both the global efficiency of the model and the closeness centrality of all doctors. This indicated a potential vulnerability in the system that could negatively impact patient care if the function of the PLN was compromised. We developed an algorithmic strategy to mitigate this risk by targeted strengthening of links between clinical teams using greedy cumulative addition of network edges in the model. Finally, we identified specific interactions along patient trajectories which were most likely to precipitate a psychiatric referral using a machine learning model trained on features from dynamically constructed clinical interaction networks. The main limitation of this study is the use of nonclinical information only (i.e., modeling is based on timing of interactions and agents involved, but not the content or quantity of information transferred during interactions). This study demonstrates a data-driven research framework, new to the best of our knowledge, to assess and reinforce important information pathways that guide clinical decision processes and provide complementary insights for improving clinical practice and operational models in emergency medicine for patients at risk of suicide or self-harm. Our findings suggest that PLNs can play a crucial role in clinical communication, but overreliance on PLNs may pose risks to reliable information flow. Operational models that utilize PLNs may be made more robust to these risks by improving interdisciplinary communication between doctors. Our research framework could also be applied more broadly to investigate service delivery in different healthcare settings or for other medical specialties, patient groups, or demographics.

Rapid access chest pain clinic; insights from 10 years of an australian experience

Abstract Introduction Rapid Access Chest Pain Clinic (RACPC) has been established in the UK as a safe and cost-effective model for managing low to intermediate Cardiovascular Disease (CVD) risk chest pain patients. In our institute, this service was established in 2012 based on the UK model. Purpose This study aimed to assess the safety, efficacy, and cost-effectiveness of the RACPC at a large metropolitan health service in Australia to inform future models of care. Patients and Methods: We conducted a retrospective analysis of consecutive patients who attended RACPC between 2012 and 2022. Patients aged 25-85 years with low to intermediate CVD risk chest pain and no previously known ischaemic heart disease were included. RACPC staff comprised of a multidisciplinary team of cardiologists, nurse practitioners, and cardiology liaison nurses. The primary outcome was to benchmark our clinic model against national peers. The secondary outcome was to examine the pattern and accuracy of requested cardiac imaging used in RACPC, identify the frequency of incidental findings resulting from imaging and determine the cost-effectiveness of RACPC. Results Over the ten-year study period, a total of 4,194 patients were seen. The median waiting time from referral to consultation was 15.5 days (5 - 21.5). Attendance rates gradually increased from 71% to 95% in the clinic's tenth year of operation. Furthermore, the number of missed appointments and cancellations decreased over the years, reaching 1% and 4%, respectively. A total of 1,758 CT Coronary Angiogram (CTCA); 1,629 functional assessments utilising either Transthoracic Stress Echocardiogram (TSE) or Myocardial Perfusion Scan (MPS), and 174 Invasive Angiography (IA) procedures were requested. 1.2% of the cohort had IA without any prior non-invasive cardiac imaging. CTCA was the most frequently requested modality and resulted in the highest rates of incidental findings (24%) such as pulmonary nodules and vascular anomalies, often leading to further investigations. The rate of non-invasive cardiac imaging resulting in IA for CTCA, TSE and MPS were 7.3%, 2.5%, and 6.4%, respectively. Revascularisation rate for positive IA, CTCA, TSE and MPS were 33.3%, 34.6%, 26.7% and 20% respectively. At our health service, and for the purpose of comparison, we encountered an average of 52 patients/year with low to intermediate CVD risk hospitalised for chest pain assessment with an average length of stay of 2.35 days at a cost of 250,000 Australian Dollars ($4808/patient). Whilst at RACPC, an average of 419 patients/year were seen with a total cost of around 62,400 A$ ($149/patient). Conclusion RACPC is a safe, efficient, and cost-effective model of care, with CTCA being the preferred modality of imaging due to its high diagnostic accuracy, high negative predictive value and high rate of significant incidental findings.

"She just makes it easier…" The impact of having a dedicated nursing role in supporting people with intellectual disability when accessing acute hospitals, from the perspective of their support staff, the Irish context.

Learning Disability Liaison Nurses have been shown to improve hospital experiences and this is an emerging role in Ireland. This research qualitatively explored the impact of a Clinical Nurse Specialist Acute Hospital Liaison from the perspective of staff in an intellectual disability community organisation. Participants identified significant challenges with supporting people attending hospitals including accessing and understanding information, anxieties and not being prepared for transitions through the hospital. The findings demonstrate the introduction of this role is a supportive, positive step with reports of improved information sharing, feeling better prepared and alleviating anxieties related to supporting someone in hospital. The findings clearly identify that this role has considerable benefits when set in a community organisation. This role has had a positive impact on service users and staff when interacting with hospitals, providing evidence of the value of this role in Ireland and also of they having a specialist qualification in the role.

SG-APSIC1062: The role of active surveillance in the primary-care setting during a pandemic in Singapore

Objectives: In response to the COVID-19 pandemic, primary care swiftly transformed and re-established patient flow in clinics to red, orange, and green zones based on a set of screening criteria. To further manage the influx of suspected COVID-19 patients and their needs safely, a list of surveillance audit criteria was developed to ensure good infection control standards. Methods: The infection control team prepared the surveillance audit criteria based on recommended CDC/WHO guidelines for pandemic preparedness. These criteria were contextualized to the primary-care polyclinic setting. The surveillance audit criteria were grouped according to their category: screening, triage, early recognition and source control, inventory management of personal protective equipment (PPE), infection control measures in the red zone, precautionary measures during collection of nasopharyngeal swabs and environmental cleaning and disinfection for premises in the red, orange, and green zones, respectively. The infection control liaison nurses in each polyclinic were trained to use the checklist to ensure consistency in interpretation of the criteria. Results: Surveillance audits were conducted biweekly in the first 3 months then monthly once the compliance rate was steady at 90%–100% for all categories. The overall average compliance rate since commencing in March 2020 for all polyclinics was sustained at 90%–100%. Common findings included inappropriate use of PPE (eg, self-contamination during removal of gown or wrong sequence of doffing), inadequate ventilation, and inadequate cleaning processes. All findings were corrected immediately, and staff education was provided. Conclusions: Primary care plays an important role during a pandemic. It is essential that both patients and healthcare workers in the primary care setting are protected from infection risk during a pandemic. Having a good surveillance audit process helps ensure that primary care services can continue for the general population. Surveillance is an essential component of the health system’s response to a pandemic.

An audit of the pharmacological management of patients experiencing acute alcohol withdrawal at a large tertiary centre

Abstract Introduction Alcohol has depressant effects on the central nervous system through its effect on inhibitory GABAA receptors. In chronic excessive alcohol use, GABAA receptors undergo neuroadaptation, and so, in abrupt alcohol withdrawal upon admission into hospital, the central nervous system remains in a hyperactive state, resulting in alcohol withdrawal syndrome (AWS), and can progress to seizures and delirium tremens if not managed appropriately. National guidance recommends validated tools such as the ‘Clinical Institute Withdrawal Assessment – Alcohol, revised’ (CIWA-Ar) scale and use of benzodiazepines and thiamine for AWS management. Within our organisation, pharmacists and the Alcohol and Drug Liaison Nurse (ADLN) specialists have noted variability in AWS management. Aim This project aimed to investigate the compliance to local and national guidelines in the management of AWS. Methods A retrospective audit (for which ethical approval was not required) was conducted using the electronic health record system to identify high-risk drinkers on the acute medical unit (AMU). A report of AMU admissions from 1st to 30th April 2020 was obtained and identified 44 patients with AWS. Patient records were analysed to assess compliance to the following standards: Standard 1 was that 100% of patients must have a completed AUDIT-C form on admission; Standard 2 was that 100% with AWS must have a CIWA-Ar score recorded every 4 hours on day one; Standard 3 was that 100% must be prescribed a benzodiazepine reducing regimen as per guidelines; and Standard 4 was that 100% with malnourishment or who will continue to consume alcohol must be discharged with thiamine 200-300mg daily. Results For Standard 1, 2% of patients (n=1) had AUDIT-C forms completed. For Standard 2, 14% (n=6) had a CIWA-Ar score measured every 4 hours on day one. For Standard 3, 23% (n=10) were prescribed benzodiazepine fixed-dose reducing regimens according to their CIWA-Ar score. 23% (n=10) had no benzodiazepines prescribed and 30% (n=13) were only prescribed a ‘when required’ benzodiazepine. 48% (n=21) were prescribed a regular benzodiazepine initially rather than a reducing regimen. Of these, 62% (13/21) were commenced on an appropriate dose according to their CIWA-Ar score. For Standard 4, 34% (n=15) were discharged on oral thiamine 200-300mg daily. 27% (n=12) were discharged without thiamine. Discussion/Conclusion The use of AUDIT-C forms was not routine practice. This may lead to under-detection of patients experiencing AWS resulting in treatment delays. CIWA-Ar scores were rarely carried out every 4 hours on day one, perhaps highlighting a need for guidance on frequency of CIWA-Ar assessment. Ten patients with AWS were not prescribed a benzodiazepine. This could have been due to a lack of awareness of guidelines, or that simplification of current guidelines is required. Limitations of this audit include that it did not explore clinical reasons for deviations from guidelines or any additional specialist advice sought from ADLN. As such, it cannot be assumed that all deviations from guidelines were inappropriate. No audit standards were met, highlighting a need to improve management of AWS in a hospital setting.

Mental health assessment – a 360° student experience

We have been developing 360° simulated practice videos for healthcare science students. The students who have taken part in the filming and watched the videos provided feedback on whether this would benefit their learning. We are doing this to continue to strive forward with innovations in virtual learning in line with Health Education England [1]. The simulation-based videos have been created to add to the healthcare sciences units to aid in ‘real-life’ teaching styles, to help build confidence and resilience in healthcare students, and to provide multidisciplinary, patient-focused scenarios that can be included in assessments [2]. First and third-year paramedic students took part in mass casualty scenarios filmed at our student’s union building. They worked with Critical Care Practitioners, Academics, Nurses in practice, and the National Ambulance Resilience Unit to create handover videos involving assessing casualties to create videos for other healthcare professionals. Follow-up videos were then filmed on the 360° cameras in the simulation suites to represent an accident and emergency environment as this is where mental health crisis assessments can take place. The adult psychosis presentation was filmed and shows ‘psychiatric liaison nurses’ played by second-year MSc and BSc mental health students assessing the person with suspected psychosis and making clinical decisions. The scenario mental state examination and the case study were scripted. Students could view the 360° videos using virtual reality headsets such as the Oculus Rift [3]. The student feedback evaluation data was collected via an online survey and focus group discussions (FGDs). A survey was completed with n=30 students across all fields of nursing students and paramedic students. The student FGD evaluations were very positive about alternative simulated learning styles with one student quoting ‘It will make an assessment of mental health patients a lot easier for students using appropriate tools and models’. Students found that simulation-based learning experience is an excellent addition to traditional learning approaches as it met the requirements for different learning styles. This research project brought together academics and practitioners from across practice and university. Future work should build on these resources based on feedback from students and service users. 1. National Health Service/Health Education England. 2020. A national vision for the role of simulation and immersive technologies in health and care. 2. ASPiH/HEE. 2016. Simulation-based Education in Healthcare Simulation-Based Education in Healthcare (aspih.org.uk) [Accessed on 17/06/2022] 3. Topal review: NHS. 2019. Preparing the healthcare workforce to deliver the digital future.

Nursing perspectives on transitional care between paediatric intensive care units and general wards: A focus group study.

We aim to explore the experiences of nursing staff in paediatric intensive care units (PICUs) and wards when transporting and caring for patients being discharged from PICU. PICU discharge is a challenging and complex procedure with risks and complications for patients. Nursing staff in PICU and paediatric wards play a pivotal role in the transition and are responsible for the quality of care, but their perspectives have rarely been explored. Focus groups were conducted between December 2021 and January 2022 with purposively sampled PICU nurses and ward nurses. Four focus groups were formed, and data were analysed using qualitative content analysis. The overarching themes were as follows: communication during handover, attitudes towards follow-up, a challenging transition for nurses and parents and suggestions for optimizing transitional procedure. Our findings provide nurses' insights and knowledge regarding the transition of patients from the PICU to the ward. Nursing strategies including the use of liaison nurses and critical training for ward nurses were considered essential to maintaining competence during transition. A well-structured handover checklist as well as interdisciplinary cooperation and transitional care units are important for the patient's quality of care. Communication, cooperation, planning and professional care are vital during the transition process. Nurse managers should work to develop collaborative approaches to facilitate safe patient transition.

COMPLEX CLINICAL HOSPITAL MODEL OF DISCHARGE MANAGEMENT: CONCEPTION AND IMPLEMENTATION

Objective: to present the conception and implementation of the Discharge Management Model of the Clinics Hospital Complex of the Federal University of Paraná. Method: experience report occurred between 2017 and 2020, about the design and implementation of the Discharge Management model with support of the logic model. Results: continuity of care and case management are operationalized by a dedicated team of liaison nurses who manage and counter-reference care to primary care and other points in the health care network. Conclusion: discharge management has been consolidated as a managerial strategy that integrates the health care network, avoids discontinuities in care, promotes patient and family safety, and optimizes beds, and inserts complex patients into the primary care agenda. It contributes to the continuity of care and represents evidence of a new field of work for nurses.

The impact of the intensive care unit family liaison nurse role on communication during the COVID-19 pandemic: A qualitative descriptive study of healthcare professionals’ perspectives

BackgroundThe COVID-19 pandemic has deeply impacted patient and family communication and patient- and family-centred care in the intensive care unit (ICU). A new role—the ICU Family Liaison Nurse (FLN)—was introduced in an Australian metropolitan hospital ICU to facilitate communication between patient and family and ICU healthcare professionals, although there is limited knowledge about the impact of this from the ICU healthcare professionals' perspectives. ObjectiveThe aim of this study was to explore the impact of the ICU FLN role on communication with patients and their family during the COVID-19 pandemic, from the ICU healthcare professionals’ perspectives. MethodsA qualitative descriptive study was conducted. Seven participants including ICU FLNs, ICU doctors, nurses, and social workers who worked with the ICU FLNs were interviewed. Thematic analysis was used to analyse the data. ResultsTwo main themes related to the ICU FLN role were identified. First, the COVID-19 pandemic posed challenges to patient and family communication, but it also created opportunities to improve patient and family communication. Second, the ICU FLN role brought beneficial impacts to the ICU healthcare professionals’ workflow and work experience, as well as patient and family communication. The ICU FLN role has potential benefits that extend beyond the pandemic. ConclusionWe found that during the COVID-19 pandemic, the ICU FLN role was acceptable, beneficial, and appreciated from the ICU healthcare professionals’ perspectives. Further research should continue the evaluation of the ICU FLN role during and post the pandemic.