Analysis of discharge documentation for older adults living with dementia: A cohort study

Background Older adults living with dementia frequently transition between healthcare settings. Care transitions increase vulnerability and risk of iatrogenic harm. Aim and objective To examine the quality of transitional care arrangements within discharge documentation for older people living with...

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Bibliographic Details
Published in:Journal of clinical nursing 2021-12, Vol.30 (23-24), p.3634-3643
Main Authors: Parker, Kirsten J., Phillips, Jane L., Luckett, Tim, Agar, Meera, Ferguson, Caleb, Hickman, Louise D.
Format: Article
Language:English
Subjects:
care continuity
cognitive impairment
Cohort analysis
Comorbidity
Continuity of care
Dementia
discharge documentation
Discharge planning
Documentation
Medical records
multimorbidity
Nursing
Nursing homes
older adults
Older people
transitional care
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Summary:Background Older adults living with dementia frequently transition between healthcare settings. Care transitions increase vulnerability and risk of iatrogenic harm. Aim and objective To examine the quality of transitional care arrangements within discharge documentation for older people living with dementia. Design Secondary analysis of cohort study data. Method A secondary analysis of the IDEAL Study [ACTRN12612001164886] discharge documents, following the STROBE guidelines. Participants had a confirmed diagnosis of dementia and were discharged from hospital to a nursing home. An audit tool was used to extract the data. This was developed through a synthesis of existing tools and finalised by an expert panel. The analysis assessed the quality of discharge documentation, in the context of transitional care needs, and presented results using descriptive statistics. Functional ability; physical health; cognition and mental health; medications; and socio environmental factors were assessed. Results Sixty participants were included in analyses, and half were male (52%), with a total participant mean age of 83 (SD 8.7) years. There was wide variability in the quality of core discharge information, ranging from excellent (37%), adequate (43%) to poor (20%). A sub‐group of these core discharge documentation elements that detailed the participants transitional care needs were rated as follows: excellent (17%), adequate (46%) and poor (37%). Conclusion Discharge documentation fails to meet needs of people living with dementia. Improving the quality of discharge documentation for people living with dementia transitioning from hospital to nursing home is critical to provide safe and quality care. Relevance to clinical practice There is a need for safe, timely, accurate and comprehensive discharge information to ensure the safety of people living with dementia and prevent adverse harm.
ISSN:0962-1067
1365-2702
DOI:10.1111/jocn.15885