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What Would Be the Optimal Conditions to Effect the Following Synthesis?

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doi: 10.1186/s12877-020-01980-3.

Understanding the positive outcomes of discharge planning interventions for older adults hospitalized following a fall: a realist synthesis

Affiliations

  • PMID: 33514326
  • PMCID: PMC7844968
  • DOI: ten.1186/s12877-020-01980-3

Gratis PMC article

Agreement the positive outcomes of belch planning interventions for older adults hospitalized following a fall: a realist synthesis

Véronique Provencher  et al. BMC Geriatr. .

Gratis PMC article

Abstract

Background: Older adults hospitalized following a fall often encounter preventable adverse events when transitioning from hospital to dwelling house. Discharge planning interventions developed to prevent these events do not all produce the expected effects to the same extent. This realist synthesis aimed to amend understand when, where, for whom, why and how the components of these interventions produce positive outcomes.

Methods: Nine indexed databases were searched to identify scientific papers and greyness literature on discharge planning interventions for older adults (65+) hospitalized post-obit a fall. Manual searches were also conducted. Documents were selected based on relevance and rigor. Two reviewers extracted and compiled information regarding intervention components, contextual factors, underlying mechanisms and positive outcomes. Preliminary theories were and then formulated based on an iterative synthesis procedure.

Results: Twenty-ane documents were included in the synthesis. Iv Intervention-Context-Mechanism-Outcome configurations were developed every bit preliminary theories, based on the following intervention components: 1) Increment ii-way communication between healthcare providers and patients/caregivers using a family-centered arroyo; 2) Foster interprofessional communication within and across healthcare settings through both standardized and unofficial data exchange; 3) Provide patients/caregivers with individually tailored fall prevention education; and four) Designate a coordinator to manage discharge planning. These components should be implemented from patient admission to render home and be supported at the organizational level (contexts) to trigger knowledge, understanding and trust of patients/caregivers, adjusted expectations, reduced family stress, and sustained date of families and professionals (mechanisms). These optimal conditions improve patient satisfaction, recovery, functional status and continuity of care, and reduce hospital readmissions and fall risk (outcomes).

Conclusions: Since transitions are critical points with potential communication gaps, coordinated interventions are vital to support a safe render home for older adults hospitalized following a autumn. Because the organizational challenges, simple tools such every bit pictograms and drawings, combined with computer-based advice channels, may optimize discharge interventions based on fragile patients' needs, habits and values. Empirically testing our preliminary theories will help to develop effective interventions throughout the continuum of transitional intendance to heighten patients' wellness and reduce the economic burden of avoidable intendance.

Keywords: Discharge planning; Falls; Older adults; Review; Transition of intendance.

Disharmonize of interest argument

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. one

Iterative process used to develop the ICMOs

Fig. 2
Fig. two

Certificate pick flowchart, OAH: older adults hospitalized, ED: emergency section, int: intervention

Fig. 3
Fig. 3

ICMO-i: Two-way communication between healthcare providers and patients/caregivers

Fig. 4
Fig. 4

ICMO-two: Interprofessional communication within and beyond healthcare settings

Fig. 5
Fig. 5

ICMO-3: Patient/caregiver individually tailored education on fall prevention

Fig. 6
Fig. 6

ICMO-4: Discharge planning coordination

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Source: https://pubmed.ncbi.nlm.nih.gov/33514326/

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