Factors That Influence Care Transitions of End-Stage Heart Failure Patients to Palliative Home Health Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/326031
Category:
Abstract
Type:
Research Study
Level of Evidence:
Cross-Sectional Study
Research Approach:
Mixed/Multi Method Research
Title:
Factors That Influence Care Transitions of End-Stage Heart Failure Patients to Palliative Home Health Care
Author(s):
Lowey, Susan
Lead Author STTI Affiliation:
Omicron Beta
Abstract:

Palliative care has been shown to be an effective way to manage distressing symptoms in end-stage heart failure, however patients are seldomly referred to palliative home care following hospital discharge for an exacerbation. The purpose of this study was to examine factors that influence referrals for palliative home care by home care coordinator nurses during the care transition process. A two-phase prospective mixed methods design was used to examine the home care referral process and factors associated with the decision making process used by home care coordinator nurses during hospital discharge of patients with NYS class IV heart failure. Phase one included audio-recorded interviews with 14 home coordinator nurses that led to the development of a 45-item online questionnaire which was distributed to a random sample of 112 home care nurses across New York State. Nurses identified a combination of patient, clinician and system related factors that impede their ability to refer patients to palliative care during the transition from hospital to home. Much of these factors were perceived by nurses to be “out of their hands” and that the decision to place patients on the palliative care team would often occur once the patient was discharged from the hospital during the initial home care assessment visit. Findings from this study shed light on the perception home care coordinators have regarding their role, and subsequently the power within that role, to place patients on the palliative home care team within their agency. Although home care coordinators appear to be in an ideal position to advocate for appropriate team placement during care transitions, multi-faceted barriers play a large role in these transitions.

Keywords:
Heart Failure; Palliative Care; Home health care
MeSH:
Heart Failure; Palliative Care; Home Care Services
Repository Posting Date:
10-Sep-2014
Date of Publication:
10-Sep-2014
Sponsors:
Sigma Theta Tau International; Hospice and Palliative Nurses Foundation
Note:
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.; This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryAbstracten
dc.typeResearch Studyen
dc.evidence.levelCross-Sectional Studyen
dc.research.approachMixed/Multi Method Researchen
dc.titleFactors That Influence Care Transitions of End-Stage Heart Failure Patients to Palliative Home Health Careen_US
dc.contributor.authorLowey, Susan-
dc.contributor.departmentOmicron Betaen
dc.identifier.urihttp://hdl.handle.net/10755/326031-
dc.description.abstract<p>Palliative care has been shown to be an effective way to manage distressing symptoms in end-stage heart failure, however patients are seldomly referred to palliative home care following hospital discharge for an exacerbation. The purpose of this study was to examine factors that influence referrals for palliative home care by home care coordinator nurses during the care transition process. A two-phase<em> </em>prospective mixed methods design was used to examine the home care referral process and factors associated with the decision making process used by home care coordinator nurses during hospital discharge of patients with NYS class IV heart failure. Phase one included audio-recorded interviews with 14 home coordinator nurses that led to the development of a 45-item online questionnaire which was distributed to a random sample of 112 home care nurses across New York State. Nurses identified a combination of patient, clinician and system related factors that impede their ability to refer patients to palliative care during the transition from hospital to home. Much of these factors were perceived by nurses to be “out of their hands” and that the decision to place patients on the palliative care team would often occur once the patient was discharged from the hospital during the initial home care assessment visit. Findings from this study shed light on the perception home care coordinators have regarding their role, and subsequently the power within that role, to place patients on the palliative home care team within their agency. Although home care coordinators appear to be in an ideal position to advocate for appropriate team placement during care transitions, multi-faceted barriers play a large role in these transitions.</p>en_GB
dc.subjectHeart Failureen_GB
dc.subjectPalliative Careen_GB
dc.subjectHome health careen_GB
dc.subject.meshHeart Failureen_US
dc.subject.meshPalliative Careen_US
dc.subject.meshHome Care Servicesen_US
dc.date.available2014-09-10T20:42:25Z-
dc.date.issued2014-09-10-
dc.date.accessioned2014-09-10T20:42:25Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
dc.description.sponsorshipHospice and Palliative Nurses Foundationen_US
dc.description.noteThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.en
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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