Search results

To analyze the quality of transitional care for patients with COVID-19 at discharge from Brazilian university hospitals.

A cross-sectional descriptive study was carried out in five Brazilian university hospitals between April and December 2021. The sample consisted of 527 participants. Data collection consisted of a sociodemographic questionnaire and the Care Transitions Measure (CTM-15), a care transition assessment instrument, which was translated and validated in Portuguese.

Most participants were patients (n = 369; 70.0%), with primary school completion (n = 218; 43.4%), multiracial (n = 218; 43.5%) and with an income of up to two minimum wages (n = 182; 42.8%). Dimension 1 – management preparation – obtained the highest score (71.2 points, SD = 16.5), while Dimension 4 – care plan – obtained the lowest score (62.2 points, SD = 23.4). Among the participating hospitals, there was a difference in the overall mean with results ranging from 67.0 to 72.9 points.

A satisfactory quality of care transition was found, considering the context of a pandemic. The main weaknesses in the care transitions were related to the care planning after hospital discharge.

Patient safety remains a top priority in healthcare. Many organizations have developed systems to monitor and prevent harm, and have invested in different approaches to quality improvement. Despite these organizational efforts to better detect adverse events, efficient resolution of safety problems remains a significant challenge. The authors developed and implemented a comprehensive multimodal patient safety improvement program called SafetyLEAP. The term “LEAP” is an acronym that highlights the three facets of the program including: a Leadership and Engagement approach; Audit and feedback; and a Planned improvement intervention. The purpose of this paper is to evaluate the implementation of the SafetyLEAP program in the intensive care units (ICUs) of three large hospitals.

A comparative case study approach was used to compare and contrast the adherence to each component of the SafetyLEAP program. The study was conducted using a convenience sample of three (n=3) ICUs from two provinces. Two reviewers independently evaluated major adherence metrics of the SafetyLEAP program for their completeness. Analysis was performed for each individual case, and across cases.

A total of 257 patients were included in the study. Overall, the proportion of the SafetyLEAP tasks completed was 64.47, 100, and 26.32 percent, respectively. ICU nos 1 and 2 were able to identify opportunities for improvement, follow a quality improvement process and demonstrate positive changes in patient safety. The main factors influencing adherence were the engagement of a local champion, competing priorities, and the identification of appropriate resources.

The SafetyLEAP program allowed for the identification of processes that could result in patient harm in the ICUs. However, the success in improving patient safety was dependent on the engagement of the care teams.

The authors developed an evidence-based approach to systematically and prospectively detect, improve, and evaluate actions related to patient safety.

To map nurses’ actions performed during the care transitions from hospital to home of Covid-19 patients.

A scoping review based on the Joanna Briggs Institute guidelines was carried out. We searched in seven databases: PubMed/MEDLINE, BDENF, LILACS, SciELO, Embase, Scopus, Web of Science and Google Scholar. A two-step screening process and data extraction was performed independently by two reviewers. The findings were summarized and analyzed using a content analysis technique.

Of the total 5,618 studies screened, 21 were included. The analysis revealed nurses’ actions before and after patient’ discharge, sometimes planned and developed with the interprofessional team. The nurses’ actions included to plan and support patients’ discharge, to adapt the care plan, to use screening tools and monitor patients’ clinical status and needs, to provide health orientation to patients and caregivers, home care and face-to-face visiting, to communicate with patients, caregivers and other health professionals with phone calls and virtual tools, to provide rehabilitation procedures, to make referrals and to orient patients and families to navigate in the health system.

The results provide a broader understanding of the actions taken and challenges faced by nurses to ensure a safe care transition for Covid-19 patients from hospital to home. The interprofessional integration to discharge planning and the clinical nursing leadership in post-discharge monitoring were highlighted.

The nurses’ actions for Covid-19 patients performed during care transitions focused on coordination and discharge planning tailored to the needs of patients and caregivers at the home setting. Nurses monitored patients, with an emphasis on providing guidance and checking clinical status using telehealth tools.