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J Pediatr Nurs. 2017 May - Jun;34:58-64. doi: 10.1016/j.pedn.2016.12.021. Epub 2017 Jan 10.

Discharge Teaching, Readiness for Discharge, and Post-discharge Outcomes in Parents of Hospitalized Children.

Author information

1
College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, United States. Electronic address: Marianne.weiss@marquette.edu.
2
College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States; Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: ksawin@chw.org.
3
College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States; Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: kgralton@chw.org.
4
College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, United States. Electronic address: Norah.Johnson@marquette.edu.
5
Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: klingbei@uwm.edu.
6
Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States; Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, United States. Electronic address: slerret@chw.org.
7
Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: mmalin@ilstu.edu.
8
School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, United States. Electronic address: yakushev@med.umich.edu.
9
College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States. Electronic address: schiffma@uwm.edu.

Abstract

PURPOSE:

This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).

DESIGN/METHODS:

In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits).

RESULTS:

Parent-reported quality of discharge teaching delivery (the way nurses teach), but not the amount of content, was positively associated with parent perception (B=0.54) and nurse assessment (B=0.16) of discharge readiness. Parent-reported discharge readiness was negatively associated with post-discharge coping difficulty (B=-0.52). Nurse assessment of discharge readiness was negatively associated with readmission; a one point increase in readiness (on a 10 point scale) decreased the likelihood of readmission by 52%.

CONCLUSION:

There is a sequential effect of quality of discharge teaching delivery on parent discharge readiness, which is associated with parent coping difficulty and child readmission.

PRACTICE IMPLICATIONS:

Efforts to improve discharge outcomes should include strategies to build nurse teaching skills for high-quality delivery of discharge teaching. In addition, routine nurse assessment of discharge readiness can be used to identify children at risk for readmission and trigger anticipatory interventions.

KEYWORDS:

Discharge readiness; Discharge teaching; Parent; Pediatric; Post-discharge; Readmission

PMID:
28087088
DOI:
10.1016/j.pedn.2016.12.021
[Indexed for MEDLINE]

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