Discharge Teaching, Readiness for Discharge, and Post-discharge Outcomes in Parents of Hospitalized Children

J Pediatr Nurs. May-Jun 2017;34:58-64. doi: 10.1016/j.pedn.2016.12.021. Epub 2017 Jan 10.

Abstract

Purpose: This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).

Design/methods: In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits).

Results: Parent-reported quality of discharge teaching delivery (the way nurses teach), but not the amount of content, was positively associated with parent perception (B=0.54) and nurse assessment (B=0.16) of discharge readiness. Parent-reported discharge readiness was negatively associated with post-discharge coping difficulty (B=-0.52). Nurse assessment of discharge readiness was negatively associated with readmission; a one point increase in readiness (on a 10 point scale) decreased the likelihood of readmission by 52%.

Conclusion: There is a sequential effect of quality of discharge teaching delivery on parent discharge readiness, which is associated with parent coping difficulty and child readmission.

Practice implications: Efforts to improve discharge outcomes should include strategies to build nurse teaching skills for high-quality delivery of discharge teaching. In addition, routine nurse assessment of discharge readiness can be used to identify children at risk for readmission and trigger anticipatory interventions.

Keywords: Discharge readiness; Discharge teaching; Parent; Pediatric; Post-discharge; Readmission.

MeSH terms

  • Adaptation, Psychological
  • Child
  • Child, Hospitalized
  • Child, Preschool
  • Continuity of Patient Care / organization & administration*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Nurse's Role
  • Parents / education*
  • Patient Discharge*
  • Patient Readmission
  • Pediatric Nursing / methods*
  • Pilot Projects
  • Quality Control
  • Risk Assessment
  • United States