An Imperative to Improve Discharge Planning: Physical Function, Length of Stay and Discharge Disposition in a Medicare Skilled Nursing Facility

2.50
Hdl Handle:
http://hdl.handle.net/10755/160073
Type:
Presentation
Title:
An Imperative to Improve Discharge Planning: Physical Function, Length of Stay and Discharge Disposition in a Medicare Skilled Nursing Facility
Abstract:
An Imperative to Improve Discharge Planning: Physical Function, Length of Stay and Discharge Disposition in a Medicare Skilled Nursing Facility
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2006
Author:Lee, Jia, PhD, RN
P.I. Institution Name:University of Missouri-Columbia
Title:Assistant Professor
Contact Address:Sinclair School of Nursing - S428 MU, Columbia, MO, 65211, USA
Contact Telephone:573-884-1693
Background: Given the pressure to reduce adverse effects of shortened hospital length of stay among older adults, it is important to understand trajectories of post-hospital function to improve discharge planning.

Objective: The purpose of this study was to identify admission factors that predict physical function at discharge, length of stay (LOS), and discharge disposition among older adults admitted to a Medicare skilled nursing facility following lower extremity surgery.

Methods: A convenience sample of 131 medical records of elderly residents was determined by a power of .80, alpha level of .05, moderate effect size of R2 = .15, and 12 possible predictors for multiple regression. Data were abstracted from the Minimum Data Set (MDS) and medical records between January 2000 and December 2002.

Results: Residents who had low physical function on admission, documentation of a pressure ulcer, loss of memory and history of falls were more likely to have low physical function at discharge, indicating targeted interventions are necessary for those residents to accelerate their post-hospital recovery. Length of stay was not significantly predicted by the admission factors including even baseline physical function. Rather than admission factors, physical function at discharge and the amount of rehabilitation therapy were related to the length of stay in this sample. The majority of residents discharged home (80%) had higher Body Mass Index (BMI) scores and was less likely to have a pressure ulcer on admission compared to those discharged to nursing homes.

Discussion: Knowing on admission those who were most at risk for poor physical function at discharge can arm nurses with critical information for better discharge planning for continuing services. Once residents most at risk are identified, targeted nursing and rehabilitation interventions need to be developed and implemented. Then, at discharge, home-based community services need to be tailored to each resident's individual needs.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAn Imperative to Improve Discharge Planning: Physical Function, Length of Stay and Discharge Disposition in a Medicare Skilled Nursing Facilityen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160073-
dc.description.abstract<table><tr><td colspan="2" class="item-title">An Imperative to Improve Discharge Planning: Physical Function, Length of Stay and Discharge Disposition in a Medicare Skilled Nursing Facility</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Lee, Jia, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Missouri-Columbia</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Sinclair School of Nursing - S428 MU, Columbia, MO, 65211, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">573-884-1693</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">leejia@missouri.edu</td></tr><tr><td colspan="2" class="item-abstract">Background: Given the pressure to reduce adverse effects of shortened hospital length of stay among older adults, it is important to understand trajectories of post-hospital function to improve discharge planning.<br/><br/>Objective: The purpose of this study was to identify admission factors that predict physical function at discharge, length of stay (LOS), and discharge disposition among older adults admitted to a Medicare skilled nursing facility following lower extremity surgery. <br/><br/>Methods: A convenience sample of 131 medical records of elderly residents was determined by a power of .80, alpha level of .05, moderate effect size of R2 = .15, and 12 possible predictors for multiple regression. Data were abstracted from the Minimum Data Set (MDS) and medical records between January 2000 and December 2002. <br/><br/>Results: Residents who had low physical function on admission, documentation of a pressure ulcer, loss of memory and history of falls were more likely to have low physical function at discharge, indicating targeted interventions are necessary for those residents to accelerate their post-hospital recovery. Length of stay was not significantly predicted by the admission factors including even baseline physical function. Rather than admission factors, physical function at discharge and the amount of rehabilitation therapy were related to the length of stay in this sample. The majority of residents discharged home (80%) had higher Body Mass Index (BMI) scores and was less likely to have a pressure ulcer on admission compared to those discharged to nursing homes.<br/><br/>Discussion: Knowing on admission those who were most at risk for poor physical function at discharge can arm nurses with critical information for better discharge planning for continuing services. Once residents most at risk are identified, targeted nursing and rehabilitation interventions need to be developed and implemented. Then, at discharge, home-based community services need to be tailored to each resident's individual needs.</td></tr></table>en_GB
dc.date.available2011-10-26T22:36:03Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:36:03Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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