Registered Nurses’ Perceptions of the Discharge Planning Process for Adult Patients in an Acute Hospital

Abstract

Background: Discharge planning is an integral part of the care undertaken by registered nurses, and yet there is research that demonstrates a lack of coherence and consistency in how registered nurses perceive discharge planning. In England, this is of national concern as discharge planning was one of 10 themes identified by the Healthcare Commission in the context of patient complaints.  The aim of this study was to explore perceptions around the discharge planning process of registered nurses working in an acute hospital.

Methods: Cross-sectional, postal survey of 461 registered nurses working in clinical areas where patients were normally discharged home. Data were collected using a discharge planning questionnaire modified for the purpose of this study.

Results: 76% of nurses agreed that discharge planning was the responsibility of patient’s allocated nurse and 79% agreed that planning should be commenced on admission to the unit.  76% agreed that an estimated discharge date was provided for each patient, but only 37% agreed that this was always communicated to patients; and 25% disagreed that patients were fully involved in the discharge planning process.  21% agreed that nurses in general lacked understanding of the discharge process.  The key roles of nurses were considered to be liaison, assessment and patient advocacy; and requisite skills focused on management and personal skills. The main barriers to discharge planning centred on poor planning and communication, inadequate staffing levels, and poor liaison with external agencies.

Conclusions: The findings indicate that despite policy changes there are identifiable issues that if addressed could improve the discharge planning process.  Most hospital patients need discharging and so it is vital that rigorous systems and processes are adopted to ensure an efficient and timely discharge.