Exploring nurses' experience of transitional care in the open-heart surgery intensive care unit and its requirements: A qualitative content analysis study
-
Sahar Khoshkesht
,
Masoumeh Zakerimoghadam
,
Maryam Esmaeili
,
Mehrzad Rahmanian
,
Shahrzad Ghiyasvandian
Abstract
Background & Aim: Transitional care is considered an effective strategy to ensure continuity of care. The comprehensive investigation of this concept and its requirements during patient transfer has been neglected. The aim of this study is to explore nurses' experience of transitional care in the open-heart surgery intensive care unit and its requirements.
Methods & Materials: This qualitative study was conducted using the conventional content analysis approach. A purposeful sampling method with maximum variation was performed among the nurses involved in the transfer process. Data were collected using 8 in-depth semi-structured interviews and analyzed using the Granheim and Lundman method.
Results: The main categories included the process of patient transfer and transitional care requirements. The sub-categories of the patient transfer process included pre-transfer, handover, and care measures after settlement in the general ward. The sub-categories of transitional care requirements included psychological preparation of the patient, the necessity of consolidating communication, maintaining continuity of care, patient education, and support, and considering the family's position in transitional care.
Conclusion: The study concluded that transitional care is an interactive and dynamic process that extends from the physician's decision to transfer the patient from the ICU to the discharge phase in the general ward. Paying attention to the requirements of transitional care can provide solutions to strengthen and organize this process. Therefore, it is suggested to apply the findings of this study in planning the strategies related to transitional care.
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13. Hennink M, Hutter I, Bailey A. Qualitative Research Methods: Sage; 2020.
14. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004;24(2):105-12.
15. Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: A focus on trustworthiness. Sage Open. 2014;4(1):2158244014522633.
16. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6): 349-57.
17. Stelfox HT, Lane D, Boyd JM, Taylor S, Perrier L, Straus S, et al. A scoping review of patient discharge from intensive care: Opportunities and tools to improve care. Chest. 2015;147(2):317-27
18. van Sluisveld N, Oerlemans A, Westert G, van der Hoeven JG, Wollersheim H, Zegers M. Barriers and facilitators to improve safety and efficiency of the ICU discharge process: A mixed methods study. BMC Health Services Research. 2017;17(1):1-12.
19. St-Louis L, Brault D. A clinical nurse specialist intervention to facilitate safe transfer from ICU. Clinical Nurse Specialist. 2011;25(6):321-6.
20. Fehlmann C, Simonet ML, Reny J-L, Stirnemann J, Blondon K. Associations between early handoffs, length of stay and complications in internal medicine wards: A retrospective study. European Journal of Internal Medicine. 2019;67:77-83.
21. Ludin SM, Arbon P, Parker S. Patients' transition in the intensive care units: concept analysis. Intensive and Critical Care Nursing. 2013;29(4):187-92.
22. Forsberg A, Lindgren E, Engström Å. Being transferred from an intensive care unit to a ward: searching for the known in the unknown. International Journal of Nursing Practice. 2011;17(2):110-6.
23. Bhowmik SR, Dasila P, Deshpande A, Bhattacharjee T. Impact of Transitional Care Strategies on Physical and Psychological parameters among ICU patients. Journal of Nursing and Health Science. 2019;8 (4): 49-53.
24. Moser DC, da Silva GA, de Oliveira Maier SR, Barbosa LC, da Silva TG. Nursing care systematization: the nurses' perception. Revista de Pesquisa, Cuidado é Fundamental Online. 2018;10(4): 998-1007.
25. Janatolmakan M, Khatony A. Explaining the experience of nurses on missed nursing care: A qualitative descriptive study in Iran. Applied Nursing Research. 2022; 63:151542.
26. Rushton M, Howarth M, Grant MJ, Astin F. Person‐centred discharge education following coronary artery bypass graft: A critical review. Journal of Clinical Nursing. 2017;26 (23-24):5206-15.
27. Li J, Mays G, Clouser JM., Du G, Stromberg A, Jack BW, et al. Information exchange among providers and patient-centeredness in transitional care: A five-year retrospective analysis. In Healthcare 2022; 10 (2): 100626.
28. DosPassos Antonio S, Bernardino E, Bueno Lelli Tominaga L, Maciel da Silva OB, Borges F, Gomez Torres D. Transition of patients from intensive care units. Journal of Nursing UFPE. 2018; 12 (12):3320-6.
29. Bucknall TK, Hutchinson AM, Botti M, McTier L, Rawson H, Hewitt NA, et al. Engaging patients and families in communication across transitions of care: an integrative review. Journal of Advanced Nursing. 2020;103(6):1104-17.
30. Josepha op‘t SAJ, Dautzenberg M, Eskes AM, Vermeulen H, Vloet LCM. The experiences and needs of relatives of intensive care unit patients during the transition from the intensive care unit to a general ward: A qualitative study. Australian Critical Care. 2020;33(6):526-32.
2. Meleis AI. Transitions theory: Middle range and situation specific theories in nursing research and practice: Springer Publishing Company; 2010.
3. Naylor MD, Aiken LH, Kurtzman ET, Olds DM, Hirschman KB. The importance of transitional care in achieving health reform. Health Affairs. 2011;30(4):746-54.
4. Thomson R, Fletcher N, Valencia O, Sharma V. Readmission to the intensive care unit following cardiac surgery: a derived and validated risk prediction model in 4,869 patients. Journal of Cardiothoracic and Vascular Anesthesia. 2018 Dec 1;32(6):2685-91.
5. Enger R, Andershed B. Nurses’ experience of the transfer of ICU patients to general wards: a great responsibility and a huge challenge. Journal of clinical nursing. 2018 Jan;27(1-2):e186-94.
6. Brown KN, Leigh JP, Kamran H, Bagshaw SM, Fowler RA, Dodek PM, Turgeon AF, Forster AJ, Lamontagne F, Soo A, Stelfox HT. Transfers from intensive care unit to hospital ward: A multicentre textual analysis of physician progress notes. Critical Care. 2018 Dec;22(1):1-8.
7. Li B, Yang Q. The effect of an ICU liaison nurse‐led family-centered transition intervention program in an adult ICU. Nursing in Critical Care. 2022; 1-11.
8. Boerenbeker P, Brandén AS, Chaboyer W, Hilli Y, Johansson L. Family member's experiences with and evaluation of an ICU Liaison Nurse Service: A qualitative study. Nursing in Critical Care. 2022. doi: 10.1111/nicc.12775. Epub ahead of print. PMID: 35396916.
9. Khoshkesht S, Ghiyasvandian S, Esmaeili M, Zakerimoghadam M. The Role of the Patients' Companion in the Transitional Care from the Open Heart Surgery ICU to the Cardiac Surgery Ward: A Qualitative Content Analysis. International Journal of Community Based Nursing and Midwifery. 2021;9(2):117-126.
10. Rayan-Gharra N, Balicer, R D, Tadmor B, Shadmi E. Association between cultural factors and re-admissions: the mediating effect of hospital discharge practices and care-transition preparedness. BMJ Quality & Safety. 2019; 28(11): 866-874.
11. van Sluisveld N, Hesselink G, van der Hoeven JG, Westert G, Wollersheim H, Zegers M. Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge. Intensive Care Medicine. 2015;41(4):589-604.
12. Shahsavari H, Zarei M, Mamaghani JA. Transitional care: Concept analysis using Rodgers' evolutionary approach. International Journal of Nursing Studies. 2019;99:103387.
13. Hennink M, Hutter I, Bailey A. Qualitative Research Methods: Sage; 2020.
14. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004;24(2):105-12.
15. Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: A focus on trustworthiness. Sage Open. 2014;4(1):2158244014522633.
16. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6): 349-57.
17. Stelfox HT, Lane D, Boyd JM, Taylor S, Perrier L, Straus S, et al. A scoping review of patient discharge from intensive care: Opportunities and tools to improve care. Chest. 2015;147(2):317-27
18. van Sluisveld N, Oerlemans A, Westert G, van der Hoeven JG, Wollersheim H, Zegers M. Barriers and facilitators to improve safety and efficiency of the ICU discharge process: A mixed methods study. BMC Health Services Research. 2017;17(1):1-12.
19. St-Louis L, Brault D. A clinical nurse specialist intervention to facilitate safe transfer from ICU. Clinical Nurse Specialist. 2011;25(6):321-6.
20. Fehlmann C, Simonet ML, Reny J-L, Stirnemann J, Blondon K. Associations between early handoffs, length of stay and complications in internal medicine wards: A retrospective study. European Journal of Internal Medicine. 2019;67:77-83.
21. Ludin SM, Arbon P, Parker S. Patients' transition in the intensive care units: concept analysis. Intensive and Critical Care Nursing. 2013;29(4):187-92.
22. Forsberg A, Lindgren E, Engström Å. Being transferred from an intensive care unit to a ward: searching for the known in the unknown. International Journal of Nursing Practice. 2011;17(2):110-6.
23. Bhowmik SR, Dasila P, Deshpande A, Bhattacharjee T. Impact of Transitional Care Strategies on Physical and Psychological parameters among ICU patients. Journal of Nursing and Health Science. 2019;8 (4): 49-53.
24. Moser DC, da Silva GA, de Oliveira Maier SR, Barbosa LC, da Silva TG. Nursing care systematization: the nurses' perception. Revista de Pesquisa, Cuidado é Fundamental Online. 2018;10(4): 998-1007.
25. Janatolmakan M, Khatony A. Explaining the experience of nurses on missed nursing care: A qualitative descriptive study in Iran. Applied Nursing Research. 2022; 63:151542.
26. Rushton M, Howarth M, Grant MJ, Astin F. Person‐centred discharge education following coronary artery bypass graft: A critical review. Journal of Clinical Nursing. 2017;26 (23-24):5206-15.
27. Li J, Mays G, Clouser JM., Du G, Stromberg A, Jack BW, et al. Information exchange among providers and patient-centeredness in transitional care: A five-year retrospective analysis. In Healthcare 2022; 10 (2): 100626.
28. DosPassos Antonio S, Bernardino E, Bueno Lelli Tominaga L, Maciel da Silva OB, Borges F, Gomez Torres D. Transition of patients from intensive care units. Journal of Nursing UFPE. 2018; 12 (12):3320-6.
29. Bucknall TK, Hutchinson AM, Botti M, McTier L, Rawson H, Hewitt NA, et al. Engaging patients and families in communication across transitions of care: an integrative review. Journal of Advanced Nursing. 2020;103(6):1104-17.
30. Josepha op‘t SAJ, Dautzenberg M, Eskes AM, Vermeulen H, Vloet LCM. The experiences and needs of relatives of intensive care unit patients during the transition from the intensive care unit to a general ward: A qualitative study. Australian Critical Care. 2020;33(6):526-32.
| Files | ||
| Issue | Vol 9 No 4 (2022): Autumn | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v9i4.11203 | |
| Keywords | ||
| transitional care intensive care unit general ward | ||
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How to Cite
1.
Khoshkesht S, Zakerimoghadam M, Esmaeili M, Rahmanian M, Ghiyasvandian S. Exploring nurses’ experience of transitional care in the open-heart surgery intensive care unit and its requirements: A qualitative content analysis study. NPT. 2022;9(4):314-325.
