Hospital and home care nurses' experiences and perspectives on collaborative discharge planning when cancer patients receiving palliative care are discharged home from hospitals

Abstract

Aims and objectives: To explore nurses’ experiences and perspectives on discharge collaboration when cancer patients receiving palliative care are sent home from hospitals. Background: Cancer patients receiving palliative care experience multiple transitions between the hospital and their home. Poor discharge collaboration is a major cause of preventable hospital readmissions. Better collaborative discharge planning could improve the management and care for these patients outside the hospital setting. Previous research has mostly been conducted in non-cancer populations. Further research regarding both home care nurses’ and hospital nurses’ perspectives on the collaboration is required. Design: A qualitative study with descriptive and explorative design. Methods: Data were collected through 10 individual, semi-structured interviews of nurses working at two oncology wards at a university hospital and home care services in four different municipalities within the hospital’s catchment area. Data were analyzed using systematic text condensation. COREQ-guidelines were adhered to in the reporting of this study. Results: Three categories emerged from the data analysis: lack of familiarity and different perceptions lead to distrust; inefficient communication creates a need for informal collaboration; and delayed discharge planning challenges optimal collaboration. Conclusions: The nurses lacked an understanding of each other’s work-situation, which created a collaboration characterized by distrust, misunderstandings and misconceptions regarding each other’s abilities to care for the patient. This led to inefficient communication, relying on individual knowledge, informal communication and personal networking. In turn, this created delays in the discharge planning, resulting in poorly prepared discharges often lacking necessary equipment and documentation. Relevance to clinical practice: To improve the care of cancer patients receiving palliative care outside the hospital setting, better communication is a key factor to promote confidence and understanding between nurses working in different levels of healthcare.