References

Dolu Í, Naharcı MI, Logan PA, Paal P, Vaismoradi M Transitional ‘hospital to home’ care of older patients: healthcare professionals' perspectives. Scand J Caring Sci. 2021; 35:871-880 https://doi.org/10.1111/scs.12904

Elkjær M, Gram B, Mogensen CB, Brabrand M, Primdahl J Readmission is experienced as inevitable among older adults receiving homecare: a qualitative interview study. Scand J Caring Sci. 2023; 37:740-751 https://doi.org/10.1111/scs.13157

Foged S, Nørholm V, Andersen O, Petersen HV Nurses' perspectives on how an e-message system supports cross-sectoral communication in relation to medication administration: a qualitative study. J Clin Nurs. 2018; 27:795-806 https://doi.org/10.1111/jocn.14109

Hansson A, Svensson A, Ahlström BH, Larsson LG, Forsman B, Alsén P Flawed communications: health professionals' experience of collaboration in the care of frail elderly patients. Scand J Public Health. 2018; 46:680-689 https://doi.org/10.1177/1403494817716001

Jones CD, Jones J, Richard A ‘Connecting the dots’: a qualitative study of home health nurse perspectives on coordinating care for recently discharged patients. J Gen Intern Med. 2017; 32:1114-1121 https://doi.org/10.1007/s11606-017-4104-0

Kalánková D, Stolt M, Scott PA, Papastavrou E, Suhonen R Unmet care needs of older people: a scoping review. Nurs Ethics. 2021; 28:149-178 https://doi.org/10.1177/0969733020948112

Kirsebom M, Wadensten B, Hedström M Communication and coordination during transition of older persons between nursing homes and hospital still in need of improvement. J Adv Nurs. 2013; 69:(4)886-895 https://doi.org/10.1111/j.1365-2648.2012.06077.x

Laugaland K, Aase K, Barach P Interventions to improve patient safety in transitional care–a review of the evidence. Work. 2012; 41:2915-2924 https://doi.org/10.3233/WOR-2012-0544-2915

Lemetti T, Stolt M, Rickard N, Suhonen R Collaboration between hospital and primary care nurses: a literature review. Int Nurs Rev. 2015; 62:248-266 https://doi.org/10.1111/inr.12147

Lemetti T, Voutilainen P, Stolt M, Eloranta S, Suhonen R An enquiry into nurse-to-nurse collaboration within the older people care chain as part of the integrated care: a qualitative study. Int J Integr Care. 2017; 17:(1) https://doi.org/10.5334/ijic.2418

Lemetti T, Puukka P, Stolt M, Suhonen R Nurse-to-nurse collaboration between nurses caring for older people in hospital and primary health care: a cross-sectional study. J Clin Nurs. 2021; 30:1154-1167 https://doi.org/10.1111/jocn.15664

Lundereng ED, Dihle A, Steindal SA Nurses' experiences and perspectives on collaborative discharge planning when patients receiving palliative care for cancer are discharged home from hospitals. J Clin Nurs. 2020; 29:(17-18)3382-3391 https://doi.org/10.1111/jocn.15371

Manias E, Bucknall T, Woodward-Kron R Interprofessional and intraprofessional communication about older people's medications across transitions of care. Int J Environ Res Public Health. 2021; 18:(8) https://doi.org/10.3390/ijerph18083925

Melby L, Brattheim BJ, Hellesø R Patients in transition – improving hospital-home care collaboration through electronic messaging: providers' perspectives. J Clin Nurs. 2015; 24:(23-24)3389-3399 https://doi.org/10.1111/jocn.12991

Møller N, Lerbæk B, Kollerup MG, Berthelsen C Building bridges from different settings to a common ground – strengthening transitions for older patients with multiple chronic conditions: a qualitative descriptive design. Nordic Journal of Nursing Research. 2023; 43:(1) https://doi.org/10.1177/20571585221114514

Moore J, Prentice D, Crawford J, Lankshear S, Limoges J, Rhodes K Collaboration among registered nurses and practical nurses in acute care hospitals: a scoping review. Nurs Forum. 2019; 54:(3)376-385 https://doi.org/10.1111/nuf.12339

Moore J, Prentice D, Crawford J Collaboration among nurses when transitioning older adults between hospital and community settings: a scoping review. J Clin Nurs. 2021; 30:2769-2785 https://doi.org/10.1111/jocn.15789

Nielsen LM, Gregersen Østergaard L, Maribo T, Kirkegaard H, Petersen KS Returning to everyday life after discharge from a short-stay unit at the emergency department-a qualitative study of elderly patients' experiences. Int J Qual Stud Health Well-being. 2019; 14 https://doi.org/10.1080/17482631.2018.1563428

Noblit GW, Hare RDH Meta-ethnography: synthesizing qualitative studies.Newbury Park: SAGE Publications Inc; 1988

Norlyk A, Deleuran CL, Martinsen B Struggles with infrastructures of information concerning hospital-to-home transitions. Br J Community Nurs. 2020; 25:10-15 https://doi.org/10.12968/bjcn.2020.25.1.10

Olsen RM, Østnor BH, Enmarker I, Hellzén O Barriers to information exchange during older patients' transfer: nurses' experiences. J Clin Nurs. 2013; 22:(19-20)2964-2973 https://doi.org/10.1111/jocn.12246

Petersen HV, Foged S, Madsen AL, Andersen O, Nørholm V Nurses' perception of how an e-message system influences cross-sectoral communication: a qualitative study. J Nurs Manag. 2018; 26:509-517 https://doi.org/10.1111/jonm.12575

Petersen HV, Foged S, Nørholm V ‘It is two worlds' cross-sectoral nurse collaboration related to care transitions: a qualitative study. J Clin Nurs. 2019; 28:(9-10)1999-2008 https://doi.org/10.1111/jocn.14805

Salmond SW, Echevarria M Healthcare transformation and changing roles for nursing. Orthop Nurs. 2017; 36:12-25 https://doi.org/10.1097/NOR.0000000000000308

van Walraven C, Bennett C, Jennings A, Austin PC, Forster AJ Proportion of hospital readmissions deemed avoidable: a systematic review. CMAJ. 2011; 183:(7)E391-402 https://doi.org/10.1503/cmaj.101860

Winqvist I, Näppä U, Rönning H, Häggström M Reducing risks in complex care transitions in rural areas: a grounded theory. Int J Qual Studies Health Well-being. 2023; 18:(1) https://doi.org/10.1080/17482631.2023.2185964

Ylitörmänen T, Kvist T, Turunen H Perceptions on nurse-nurse collaboration among registered nurses in Finland and Norway. Scand J Caring Sci. 2019; 33:731-740 https://doi.org/10.1111/scs.12669

Discharging older patients from hospital to homecare: conflicts in collaborative practices among nurses across sectors

02 July 2024
Volume 29 · Issue 7

Abstract

Background:

Collaboration is a key factor influencing the quality and safety in patients transition between sectors. However, specific collaborative practices may give rise to conflict between hospital nurses and community nurses.

Aims:

To gain a deeper understanding of collaborative practices which have the potential to fuel tension in collaboration between hospital nurses and community nurses during discharge of older patients from hospital to homecare.

Methods:

A meta-ethnography approach was used in this study and a systematic literature search was conducted in 2022.

Results:

Five themes were identified in the analysis. These themes revealed how uncertainty, limited confidence in information and personal attitude in communication may fuel tension between hospital nurses and community nurses. Tensions arising from a negative loop emerged because of uncertainty, causing a growing rift between hospital nurses and community nurses, leaving them as opponents rather than collaborators. The authors suggest that policy makers and managers can break this loop by underpinning shared policies and awareness of common objectives.

Demographic shifts and hospital reorganisations mean that patients are discharged to their homes at a much faster rate and with more comprehensive healthcare needs than previously (Salmond and Echevarria, 2017; Ylitörmänen et al, 2019). This trend is especially pronounced among older patients for whom the transition from hospital to homecare is marked by an even higher level of complexity than in other patient groups (Norlyk et al, 2020; Moore et al, 2021). Consequently, homecare services face a growing demand to address these comprehensive care needs of the older population, ensure seamless treatment trajectories and deliver quality healthcare (Hansson et al, 2018; Norlyk et al, 2020; Dolu et al, 2021).

Register now to continue reading

Thank you for visiting Community Nursing and reading some of our peer-reviewed resources for district and community nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month