Paper
Friday, 21 July 2006
This presentation is part of : Using Evidence to Approach Child Healthcare Issues
Readiness for Discharge for Parents of Hospitalized Children: Predictors and Outcomes
Norah Louise Johnson, MSN, RN, CPNP1, Marianne Weiss, RN, DNS1, Michelle Malin, PhD, RN2, and Linda B. Piacentine, MS, RN, ACNP1. (1) College of Nursing, Marquette University, Milwaukee, WI, USA, (2) Nursing, Childrens Hospital of Wisconsin, Milwaukee, WI, USA
Learning Objective #1: identify parent and hospitalization characteristics that predict readiness for hospital discharge.
Learning Objective #2: describe the impact of parent education and care coordination during hospitalization on parental readiness for discharge, as an outcome of the hospitalization phase.
Background: Parents’ perceptions of  ‘readiness for discharge’ have been inadequately studied. In the pediatric population, the effect of nursing practice on readiness for discharge is generally centered on the knowledge-based preparation instead of parent perception of readiness.

Purpose: The purpose of this study is to identify the relationships of parent characteristics, hospitalization characteristics, and the nursing practices of parent education and care coordination as predictors of parents’ perceptions of readiness at the time of hospital discharge and outcomes after discharge.  Meleis’ (2000) Transitions theory was used as a guiding framework for variable identification.Sample: A convenience sample of 135 English speaking parents, at least 18 years old, with hospitalized children anticipating discharge home, was recruited.  119 completed all aspects of the study.

Methods & Design:  In this correlational, longitudinal study, data were collected prior to hospital discharge and 3 weeks post-discharge.  Measurement scales include the Quality of Discharge Teaching Scale (QDTS), Care Coordination Scale (CCS), Readiness for Hospital Discharge Scale (RHDS) and the Post-Discharge Coping Difficulty scale (PDCDS). Results: Number of children and nurses’ skill in delivery of the education accounted for 18% of the variance in readiness for discharge. Scores on the RHDS accounted for 7 % of the variance on the PDCDS. PDCDS scores were predictive of use of post-discharge support and services.
Conclusions & Implications:  Further work on the RHDS scale focusing on utility in the clinical practice environment is needed, particularly the use of the RHDS as an outcome measure of hospitalization as a guide to identification of parents at risk for adverse post-discharge outcomes.  Hospital-based nurse discharge teaching has implications beyond discharge. The skillful delivery of patient education content appears to be more important than the amount of content in promoting readiness for discharge.
 

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