Influences on fit between psychiatric patients' psychosocial needs and their hospital discharge plan

1997 ◽  
Vol 48 (4) ◽  
pp. 518-523 ◽  
Keyword(s):  
Hospital Discharge ◽  
Psychiatric Patients ◽  
Psychosocial Needs ◽  
Discharge Plan

scholarly journals Association of continuity of care with readmission, mortality and suicide after hospital discharge among psychiatric patients

2020 ◽  
Vol 32 (9) ◽  
pp. 569-576
Author(s):  
Young Choi ◽  
Chung Mo Nam ◽  
Sang Gyu Lee ◽  
Sohee Park ◽  
Hwang-Gun Ryu ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Continuity Of Care ◽  
Psychiatric Patients ◽  
Psychiatric Inpatients ◽  
Post Discharge ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Nested Case Control ◽  
Control Study

Abstract Objectives The objective of this study was to identify the association between continuity of ambulatory psychiatric care after hospital discharge among psychiatric patients and readmission, mortality and suicide. Design Nationwide nested case-control study. Settings South Korea. Participants Psychiatric inpatients. Interventions Continuity of psychiatric outpatient care was measured from the time of hospital discharge until readmission or death occurred, using the continuity of care index. Main Outcome Measures Readmission, all-cause mortality and suicides within 1-year post-discharge. Results Of 18 702 psychiatric inpatients in the study, 8022 (42.9%) were readmitted, 355 (1.9%) died, and 108 (0.6%) died by suicide within 1 year after discharge. Compared with the psychiatric inpatients with a high continuity-of-care score, a significant increase in the readmission risk within 1 year after discharge was found in those with medium and low continuity of care scores. An increased risk of all-cause mortality within 1 year after hospital discharge was shown in the patients in the low continuity group, relative to those in the high-continuity group. The risk of suicide within 1 year after hospital discharge was higher in those with medium and low continuity of care than those with high continuity of care. Conclusion The results of this study provide empirical evidence of the importance of continuity of care when designing policies to improve the quality of mental health care, such as increasing patient awareness of the importance of continuity and implementation of policies to promote continuity.

scholarly journals Newly Initiated In-Hospital Antipsychotics Continued at Discharge in Non-psychiatric Patients

2018 ◽  
Vol 53 (5) ◽  
pp. 308-315 ◽  
Author(s):  
Gabriel V. Fontaine ◽  
Whitney Mortensen ◽  
Kathryn M. Guinto ◽  
Danielle M. Scott ◽  
Russell R. Miller
Keyword(s):  
Health Care ◽  
Hospital Discharge ◽  
Health Care System ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Psychiatric Illness ◽  
Psychiatric Patients ◽  
Final Analysis ◽  
To Receive ◽  
Care System

Objectives: Antipsychotics are commonly initiated in the hospital for agitation and delirium and may be inappropriately continued upon floor transfer and at discharge. We sought to evaluate the magnitude of this issue within our health care system. Methods: We conducted a multicenter, retrospective cohort study within a 22-hospital health care system to evaluate the proportion of patients without identifiable psychiatric illness who received newly initiated inpatient antipsychotics and were then continued on an antipsychotic at hospital discharge. Results: Of 23 049 patients who received at least 1 in-hospital dose of haloperidol, olanzapine, quetiapine, risperidone, or ziprasidone, 8297 patients were included in the final analysis after applying exclusion for identifiable psychiatric illness or previous antipsychotic use. Ultimately, 334 patients (4%) were discharged with a new antipsychotic prescription. Patients receiving antipsychotics at discharge were more likely as an inpatient to receive quetiapine (77.2% vs 35.9%; odds ratio [OR]: 6.1, 95% confidence interval [CI]: 4.7-8.0; P < .001) and less likely to receive haloperidol (15% vs 47%; OR: 0.2, 95% CI: 0.14-0.27; P < .001) or olanzapine (16.2% vs 20.9%; OR: 0.73, 95% CI: 0.53-0.98; P < .04). Conclusions: Antipsychotics may be inappropriately continued in non-psychiatric patients at hospital discharge. Strategies to limit potentially unnecessary antipsychotics upon discharge should be evaluated.

scholarly journals Hospital discharge plan for patients with congestive heart failure

2011 ◽  
Vol 19 (6) ◽  
pp. 1445-1452 ◽  
Author(s):  
Maria Paula Andrietta ◽  
Rita Simone Lopes Moreira ◽  
Alba Lucia Bottura Leite de Barros
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Health Education ◽  
Hospital Discharge ◽  
Nursing Care ◽  
Self Care ◽  
Integrative Review ◽  
Inclusion Criteria ◽  
Discharge Plan ◽  
Potential Factors

This integrative review investigates how nurses plan the hospital discharge of patients with Congestive Heart Failure (CHF) since an inadequate discharge plan and patients’ subsequent non-adherence to instruction provided upon discharge are indicated as potential factors for re-hospitalization. A total of 24 papers were found in a search carried out in the LILACS and MEDLINE databases between 2004 and 2008, which given the inclusion criteria, were reduced to 14 papers. The papers were analyzed and categorized into ‘Health Education’, and ‘Nursing Care’. The synthesis of results indicates that the discharge plan devised by nurses is based on two categories. The actions of nurses to promote health education can enable patients with CHF to improve self-care.

Predictors of Medication Compliance After Hospital Discharge in Adolescent Psychiatric Patients

1998 ◽  
Vol 8 (2) ◽  
pp. 133-141 ◽  
Author(s):  
ANNE LLOYD ◽  
WILLIAM HORAN ◽  
SUSAN R. BORGARO ◽  
JOHN M. STOKES ◽  
DAVID L. POGGE ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Medication Compliance ◽  
Psychiatric Patients

scholarly journals The Wessex Recent In-Patient Suicide Study, 1

2001 ◽  
Vol 178 (6) ◽  
pp. 531-536 ◽  
Author(s):  
Elizabeth A. King ◽  
David S. Baldwin ◽  
Julia M. A. Sinclair ◽  
Nigel G. Baker ◽  
Michael J. Campbell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Discharge ◽  
Suicide Risk ◽  
Care Delivery ◽  
Psychiatric Patients ◽  
Retrospective Case ◽  
Patient Suicide ◽  
Increased Risk ◽  
Discharged Patients ◽  
History Of

BackgroundPsychiatric patients have a higher suicide risk following hospital discharge.AimsTo identify social, clinical and health-care delivery factors in recently discharged patients.MethodRetrospective case-control study of 234 patients who died within 1 year of hospital discharge, matched for age, gender, diagnosis and admission period with 431 controls. Odds ratios for identified risk factors were calculated using conditional multiple logistic regression.ResultsIndependent increased-risk factors were: not being White; living alone; history of deliberate self-harm (DSH); suicidal ideation precipitating admission; hopelessness; admission under different consultant; onset of relationship difficulties; loss of job; in-patient DSH; unplanned discharge; significant care professional leaving/on leave. Reduced-risk factors were: shared accommodation; delusions at admission; misuse of non-prescribed substances; and continuity of contact.ConclusionsContinuity of contact may reduce suicide risk. Discontinuity of care from a significant professional is associated with increased risk of suicide.

Health and Psychosocial Needs of Older Adults Who Are Experiencing Homelessness Following Hospital Discharge

2019 ◽  
Vol 60 (4) ◽  
pp. 715-724 ◽  
Author(s):  
Sarah L Canham ◽  
Karen Custodio ◽  
Celine Mauboules ◽  
Chloe Good ◽  
Harvey Bosma
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Hospital Discharge ◽  
Health Care Providers ◽  
Social Needs ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Structured Interviews ◽  
Common Location ◽  
Housing Options

Abstract Introduction Though hospitals are a common location where older adults experiencing homelessness receive health care, an understanding of the types of supports needed upon hospital discharge is limited. We examined the unique characteristics of older homeless adults and the health and psychosocial supports required upon hospital discharge. Design and Methods Guided by principles of community-based participatory research (CBPR), we conducted 20 in-depth, semi-structured interviews with shelter/housing and health care providers in Metro Vancouver. Results Thematic analyses revealed 6 themes: (a) older people experiencing homelessness have unique vulnerabilities upon hospital discharge; (b) following hospital discharge, general population shelters are inappropriate for older adults; (c) shelter/housing options for older adults who have complex health and social needs are limited; (d) shelter/housing for older adults who require medical stabilization and convalescence after hospital discharge is needed; (e) a range of senior-specific shelter/housing options are needed; and (f) unique community supports are needed for older adults upon hospital discharge. Discussion and Implications As the population of older adults increases across North America, there is a parallel trend in the increased numbers of older adults who are experiencing homelessness. Not only is there often a need for ongoing medical care and respite, but there is a need for both shelter and housing options that can appropriately support individual needs.

scholarly journals Planejamento nutricional da alta hospitalar: breve revisão da literatura e proposta de instrumento de avaliação

2021 ◽  
Vol 4 (35) ◽  
pp. 329-339
Author(s):  
Rodrigo Costa Gonçalves ◽  
Maria Carolina Gonçalves Dias ◽  
Nara Lucia Andrade Lopes Segadilha ◽  
Ana Cristina Schmidt de Oliveira-Netto ◽  
Maria do Socorro Lira Paes Batista ◽  
...  
Keyword(s):  
Health Care ◽  
Hospital Stay ◽  
Hospital Discharge ◽  
Discharge Planning ◽  
Health Care Service ◽  
Family Members ◽  
Hospital Environment ◽  
Multiprofessional Team ◽  
Nutritional Care ◽  
Discharge Plan

Introduction: Due to its frequency and potential consequences, malnutrition is a worrisome condition in the hospital environment, especially in the case of adults admitted to intensive care units and others at high risk; malnutrition is associated with a higher risk of morbidity and mortality, prolonged hospital stay, higher frequency of readmissions, and increased costs. Although the absence of a planning for hospital discharge can aggravate these consequences, there are no guidelines for nutritional planning for hospital discharge that can be widely adopted in Brazil. Methods: A panel of experts was convened to assess the most relevant topics in the literature related to hospital discharge planning, discuss their experience in this regard, and propose an instrument that could guide and justify the importance of planned and safe nutrition discharge. Results: An organized and explicit discharge plan brings clinical and nutritional benefits to the patient, as well as advantages for family members and the health-care service. Nutritional care and better communication and guidance from the multiprofessional team prepare the patient and family members to reduce length of hospital stay and may avoid readmissions. Discharge planning requires the development of an individualized plan, as well as the education of the patient, family and caregivers; the nutritional care plan is inserted in the discharge plan. Based on these considerations, we propose an instrument that aims to systematize the nutritional discharge through the collection of the most relevant information related to the nutritional risk and the therapeutic approach to this risk, standardizing the communication with the patient, their caregivers, and the health-care team. Conclusions: The instrument presented here should be tested in clinical practice, and it is hoped that it can allow a better follow-up of the patient’s journey, leading to a more successful hospital discharge.

scholarly journals CONTINUITY OF HOSPITAL DISCHARGE CARE FOR PRIMARY HEALTH CARE: SPANISH PRACTICE

2020 ◽  
Vol 29 ◽  
Author(s):  
Maria Fernanda Baeta Neves Alonso da Costa ◽  
Suely Itsuko Ciosak ◽  
Selma Regina de Andrade ◽  
Cilene Fernandes Soares ◽  
Esperanza I. Ballesteros Pérez ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Hospital Discharge ◽  
Continuity Of Care ◽  
University Hospitals ◽  
Online Questionnaire ◽  
Primary Health ◽  
Discharge Care ◽  
Discharge Plan

ABSTRACT Objective: to understand discharge plan and the facilities and difficulties for continuity of care in Primary Health Care. Method: a qualitative and exploratory study carried out in Madrid, Barcelona, Murcia, Seville and Granada, with 29 hospital liaison nurses working in university hospitals, between 2016 and 2018. For data collection, an online questionnaire was used with open and closed questions about the profile of nurses; work context; hospital discharge plan; communication between hospital nurses and primary care. All were analyzed based on Thematic Analysis. Results: hospital liaison nurses from Spain draw up a discharge plan at least 48 hours in advance. They offer a Continuity of Care Report, guide patients, families and caregivers to the necessary care after hospital discharge, coordinate consultations and referrals and carry out home visits. Communication with primary care occurs through the computerized system and telephone. Monitoring takes place using indicators and statistical reports. In cases of readmission, nurses are requested and contacted by nurses in primary care. Communication with primary care is among the facilities. Lack of liaison nurses is among the difficulties. Conclusion: hospital liaison nurses from Spain carry out a discharge plan and communicate with primary care. When patients are hospitalized, they are called when there is a need for continuity of care for primary care.

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