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Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study

BACKGROUND: Emergency department visits and hospital admissions are common among nursing home residents (NHRs) and seem to be higher in Germany than in other countries. Yet, research on characteristics of transfers and involved persons in the transfer decision is scarce. AIMS: The aim of this study...

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Autores principales: Pulst, Alexandra, Fassmer, Alexander Maximilian, Schmiemann, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302553/
https://www.ncbi.nlm.nih.gov/pubmed/33258074
http://dx.doi.org/10.1007/s40520-020-01751-5
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author Pulst, Alexandra
Fassmer, Alexander Maximilian
Schmiemann, Guido
author_facet Pulst, Alexandra
Fassmer, Alexander Maximilian
Schmiemann, Guido
author_sort Pulst, Alexandra
collection PubMed
description BACKGROUND: Emergency department visits and hospital admissions are common among nursing home residents (NHRs) and seem to be higher in Germany than in other countries. Yet, research on characteristics of transfers and involved persons in the transfer decision is scarce. AIMS: The aim of this study was to analyze the characteristics of hospital transfers from nursing homes (NHs) focused on contacts to physicians, family members and legal guardians prior to a transfer. METHODS: We conducted a multi-center study in 14 NHs in the regions Bremen and Lower Saxony (Northwestern Germany) between March 2018 and July 2019. Hospital transfers were documented for 12 months by nursing staff using a standardized questionnaire. Data were derived from care records and perspectives of nursing staff and were analyzed descriptively. RESULTS: Among 802 included NHRs, n = 535 unplanned hospital transfers occurred of which 63.1% resulted in an admission. Main reasons were deterioration of health status (e.g. fever, infections, dyspnea and exsiccosis) (35.1%) and falls/accidents/injuries (33.5%). Within 48 h prior to transfer, contact to at least one general practitioner (GP)/specialist/out-of-hour-care physician was 46.2% and varied between the NHs (range: 32.3–83.3%). GPs were involved in only 34.8% of transfer decisions. Relatives and legal guardians were more often informed about transfer (62.3% and 66.8%) than involved in the decision (21.8% and 15.1%). DISCUSSION: Contacts to physicians and involvement of the GP were low prior to unplanned transfers. The ranges between the NHs may be explained by organizational differences. CONCLUSION: Improvements in communication between nursing staff, physicians and others are required to reduce potentially avoidable transfers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40520-020-01751-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-83025532021-07-27 Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study Pulst, Alexandra Fassmer, Alexander Maximilian Schmiemann, Guido Aging Clin Exp Res Original Article BACKGROUND: Emergency department visits and hospital admissions are common among nursing home residents (NHRs) and seem to be higher in Germany than in other countries. Yet, research on characteristics of transfers and involved persons in the transfer decision is scarce. AIMS: The aim of this study was to analyze the characteristics of hospital transfers from nursing homes (NHs) focused on contacts to physicians, family members and legal guardians prior to a transfer. METHODS: We conducted a multi-center study in 14 NHs in the regions Bremen and Lower Saxony (Northwestern Germany) between March 2018 and July 2019. Hospital transfers were documented for 12 months by nursing staff using a standardized questionnaire. Data were derived from care records and perspectives of nursing staff and were analyzed descriptively. RESULTS: Among 802 included NHRs, n = 535 unplanned hospital transfers occurred of which 63.1% resulted in an admission. Main reasons were deterioration of health status (e.g. fever, infections, dyspnea and exsiccosis) (35.1%) and falls/accidents/injuries (33.5%). Within 48 h prior to transfer, contact to at least one general practitioner (GP)/specialist/out-of-hour-care physician was 46.2% and varied between the NHs (range: 32.3–83.3%). GPs were involved in only 34.8% of transfer decisions. Relatives and legal guardians were more often informed about transfer (62.3% and 66.8%) than involved in the decision (21.8% and 15.1%). DISCUSSION: Contacts to physicians and involvement of the GP were low prior to unplanned transfers. The ranges between the NHs may be explained by organizational differences. CONCLUSION: Improvements in communication between nursing staff, physicians and others are required to reduce potentially avoidable transfers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40520-020-01751-5) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-11-30 2021 /pmc/articles/PMC8302553/ /pubmed/33258074 http://dx.doi.org/10.1007/s40520-020-01751-5 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Pulst, Alexandra
Fassmer, Alexander Maximilian
Schmiemann, Guido
Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study
title Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study
title_full Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study
title_fullStr Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study
title_full_unstemmed Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study
title_short Unplanned hospital transfers from nursing homes: who is involved in the transfer decision? Results from the HOMERN study
title_sort unplanned hospital transfers from nursing homes: who is involved in the transfer decision? results from the homern study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302553/
https://www.ncbi.nlm.nih.gov/pubmed/33258074
http://dx.doi.org/10.1007/s40520-020-01751-5
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