Meta-analysis of the effectiveness of nursing discharge planning interventions for older inpatients discharged home

J Adv Nurs. 2018 Apr;74(4):788-799. doi: 10.1111/jan.13475. Epub 2017 Nov 17.

Abstract

Aim: To determine the effectiveness of nursing discharge planning interventions on health-related outcomes for older inpatients discharged home.

Background: Inadequate discharge planning for the ageing population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing interventions for older people. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be evaluated in practice.

Design: Systematic review and meta-analysis.

Data sources: A systematic search was undertaken across 13 databases to retrieve published and unpublished studies in English between 2000-2015.

Review methods: Critical appraisal, data extraction and meta-analysis followed the methodology of the Joanna Briggs Institute.

Results: Thirteen studies were included in the review, 2 of 13 were pilot studies and one had a pre-post design. Included studies involved 3,964 participants with a median age of 77 years. Nurse discharge planning did not significantly reduce hospital readmission or quality of life, except readmission was lower across studies conducted in the USA. The overall effect score for nurse discharge planning on length of stay was statistically significant and positive.

Conclusion: Nursing discharge planning is a complex intervention and difficult to evaluate. Findings suggest that nursing discharge planning for older inpatients discharged home increases the length of stay yet neither reduces readmission rate nor improves quality of life.

Keywords: aged; discharge planning; hospitalization; meta-analysis; nursing; quantitative systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Nursing Service, Hospital / statistics & numerical data*
  • Patient Discharge / statistics & numerical data*
  • Patient Outcome Assessment*
  • Patient Transfer / methods*
  • Patient Transfer / statistics & numerical data*