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Home-care nurses’ perceptions of unmet information needs and communication difficulties of older patients in the immediate post-hospital discharge period
Open accessAbstract
Objective: To understand home-care nurses’ perceptions of the post-hospitalisation information needs and communication problems of older patients, and how these factors might contribute to undesirable outcomes including poor patient reintegration into prior living environments and unplanned hospital readmissions. Design: A ranked list of information needs experienced by patients was developed by two Nominal Group Technique (NGT) sessions from the perspective of home-care nurses. The list was combined with results from previously published work to develop a web-based survey administered to home-care nurses to elicit perceptions of patients’ post-hospitalisation information needs. Results: Seventeen nurses participated in the NGT sessions, producing a list of 28 challenges grouped into five themes: medications, disease/condition, non-medication care/treatment/safety, functional limitations and communication problems. The survey was sent to 220 home-care nurses, with a 54.1% (119/220) response rate. Respondents identified several frequent, high-impact information and communication needs that have received little attention in readmission literature, including information about medication regimens; the severity of their condition; the hospital discharge management process; non-medication care regimens such as wound care, use of durable medical equipment and home safety; the extent of care needed; and which providers are best suited to provide that care. Responses also identified several communication difficulties that may play a role in readmissions. Conclusions: Information needs and communication problems identified by home-care nurses expanded upon and reinforced results from prior studies. These results might be used to develop interventions that may improve information sharing among clinicians, patients and caregivers during care transitions to ensure patient reintegration into prior living environments, potentially preventing unplanned hospital readmissions.
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Whenever older adults were moved from hospitals to home or nursing care, changes to their medications and administration instructions would change.
“Whenever older adults were moved from hospitals to home or nursing care, changes to their medications and administration instructions would change.”
From Benefits of, Barriers to, and Needs for an Artificial Intelligence–Powered Medication Information Voice Chatbot for Older Adults: Interview Study With Geriatrics Experts (2022) · cites this paper as [15]
The Introduction describes hospital-to-home care transitions, and the Discussion’s “Information Need Themes” section reports discrepancies in medication information and unmet needs concerning medication regimens. It does not say that medications and administration instructions change whenever older adults move, or establish this for transfers to nursing care. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn such cases, home care nurses played a big role in helping the older adults adapt and follow the new medication changes and manage medication compliance.
“In such cases, home care nurses played a big role in helping the older adults adapt and follow the new medication changes and manage medication compliance.”
From Benefits of, Barriers to, and Needs for an Artificial Intelligence–Powered Medication Information Voice Chatbot for Older Adults: Interview Study With Geriatrics Experts (2022) · cites this paper as [15]
The Introduction describes home-care nurses as providing in-home nursing care and education after discharge. The Discussion’s “Information Need Themes” identifies medication adherence and regimen information as important problems, while “Care Transitions and Information Continuity” says patients may need explanations from a home-care nurse. The paper does not establish that nurses actually helped older adults adapt to medication changes or managed their compliance; it studies nurses’ perceptions of unmet needs. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe study's finding supports previous studies that describe the post-discharge period as a vulnerable time for these patients.
“Our finding supports previous studies that describe the post-discharge period as a vulnerable time for these patients [33, 34].”
From The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping (2023) · cites this paper as [34]
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Vincent, C., & Amalberti, R. (2016) · doi:10.1007/978-3-319-25559-0 · Cited by 278
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“Our finding supports previous studies that describe the post-discharge period as a vulnerable time for these patients [33, 34].”
Result
Metadata
- Authors
- Romagnoli, K. M., Handler, S. M., Ligons, F. M., & Hochheiser, H.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Romagnoli, Katrina M
- Venue
- BMJ Quality & Safety
- Publisher
- BMJ
- Published
- 2013-01-29
- Volume
- 22
- Issue
- 4
- Pages
- 324-332
- ISSN
- 1475-3898 (ISSN-L)
- 2044-5415
- 2044-5423
- PMC
- PMC3694324
- OpenAlex
- W2144992913
- Cited by
- 59
- References
- 43
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 8 · 2020: 3 · 2019: 6 · 2018: 6 · 2017: 6 · 2016: 5 · 2015: 3 · 2014: 4 · 2013: 2
- FWCI
- 4.61
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- BMJ Quality & Safety (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Pittsburgh
- National Institutes of Health (5k07ag033174-05)
- Agency for Healthcare Research and Quality (R01HS018721)
- National Institute on Aging (R01AG027017, K07AG033174-01A1, K07‐AG033174, P30AG024827, T32AG021885)
- U.S. National Library of Medicine (T15LM007059)
- Topics
- Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Keywords
- home care nurses, information needs, communication difficulties, elderly patients, post-hospital discharge, unplanned hospital readmission, care transitions, patient reintegration, drug information, home safety, wound care, durable medical equipment, functional limitations, patient-provider communication
- MeSH terms
- Adult, Aged, Communication, Female, Health Services Needs and Demand, Home Care Services, Humans, Male, Middle Aged, Patient Compliance, Patient Discharge, Perception, Self Care, Young Adult, Nurses, Community Health
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