Transferring dying nursing home residents to the hospital: DON perspectives on the nurse’s role in transfer decisions

This qualitative study elicits factors that influence decision-making by nurses about transferring a dying resident from the nursing home to the hospital. Focus groups with directors of nursing (DONs) from long-term care facilities revealed those decisions are influenced by knowledge (or lack thereo...

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Bibliographic Details
Published in:Geriatric nursing (New York) 2001-11, Vol.22 (6), p.313-317
Main Authors: Bottrell, Melissa M., O’Sullivan, James F., Robbins, Melissa A., Mitty, Ethel L., Mezey, Mathy D.
Format: Article
Language:English
Subjects:
Decision Making
Focus Groups
Hospitalization
Humans
Managed Care Programs
Nurse Administrators
Nurse's Role
Nursing
Nursing Homes - organization & administration
Patient Transfer - organization & administration
Physician-Nurse Relations
Terminally Ill
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Summary:This qualitative study elicits factors that influence decision-making by nurses about transferring a dying resident from the nursing home to the hospital. Focus groups with directors of nursing (DONs) from long-term care facilities revealed those decisions are influenced by knowledge (or lack thereof) of resident or family preferences, nurse interactions with physicians, nursing home technological and personnel resources, and nurse concerns about institutional liability. DONs can improve transfer decisions by communicating with all parties, clarifying nursing home processes for end-of-life care, and scheduling early and thorough conversations with residents and families about end-of-life care. DONs can implement improvements through staff education on communication issues, rigorous evaluation and performance outcome measures related to patient transfer, and conveyance to staff of the institution’s mission and the nursing service’s values. (Geriatr Nurs 2001;22:313-7)
ISSN:0197-4572
1528-3984
DOI:10.1067/mgn.2001.120994