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Reviews related to readmission to the hospital nursing essay

This chapter deals with the related literature review which aids to generate a picture of what is known and not known about a particular situation. Geri LoBiondo-Wood et al (2011), stated that Review of literature is an organized critique of important scholarly literature which supports a study and a key step in research process.

Jahn P et al (2010) conducted a cluster randomized multicenter trial among 24 patient who were diagnosed with malignancy and having pain more than 3 days in California. A trans institutional multi modular nursing intervention protocol was administered to the patients. The study result revealed that the patients who received multi modular structured intervention had less patient related barrier and a better self management for cancer pain.

Bonnema (2009) conducted a cohort study to assess the impact of different adherence levels to the Enhanced Recovery after Surgery Protocol (ERAS) and the effect of various enhanced recovery after surgery elements on outcomes following major surgery in France. 953 patients with colorectal cancer were selected. It was found that following an increase in preoperative, perioperative adherence to the ERAS protocol both postoperative complication (<95%) and symptoms (95%) declined significantly

Filiz et al (2008) conducted an experimental study to assess the effectiveness of inpatient discharge instruction on self care among patients in Brazil. Pictograms were used to enhance two mock up discharge instruction. The study findings showed that there was statistically significant better recall rate (p <0. 001). The study concluded that patient comprehension and recall of discharge instruction improved with pictographs.

Horn et al (2010) conducted a randomized trial to assess the self management of cancer pain among 240 cancer patients after discharge in Germany. A structured intervention protocol was used to improve self management in cancer patients having pain. The patient in the control group will receive standard care and for experimental group structured intervention protocol. The study concluded that patients who received the structured intervention had less pain level than standard care.

Glen T et al (2012) conducted an interventional study to identify the beneficial role of nutrition and supportive therapy for cancer clients and the nurses’ perception of nutrition education to cancer client, in Columbia among 90 samples. An interview schedule was conducted by the oncology nurse regarding the nutrition information of cancer clients. The findings suggested that oncology nurses consider patient education about nutrition at a personal level had high success rate.

Oluwatosin et al (2009) conducted a descriptive study to assess the information resources used by the cancer patient to learn about the chemotherapy side effects in Sydney. 31ovarian cancer patients and 81 men with various cancer diagnoses were selected. The information sources used are doctors, nurses, own reading, friends and relatives. The data showed that more than 90% patients, frequently visited doctors and nurses as a information source to learn about the side effects.

Solomon MJ et al (2011) conducted a retrospective study to identify unmet supportive care needs of people with colorectal cancer following discharge from hospital among521 patients in Sydney . The study findings showed that 42% patients had unmet supportive care needs. The study concluded that interaction of oncology nurse with patients can provide information about unmet supportive care needs.

De leeu wj et al (2011) conducted a descriptive study. The aim of the study was to gain insight into discharge advice and to determine the factors that hinder the actual adoption of discharge advice by patients. The study samples include 21 head and neck cancer patients in Minnesota using structured interviews. The study findings revealed that the influencing factors include behavior, communication and efficacy of advice. The study concluded that the discharge advice that is given to the patients is very complex to understand for the patients.

Tsuchiya M et al (2009) conducted an experimental study to assess the unmet information needs among breast cancer patients among 42 patients in Japan and conducted a semi structured face to face interviews. The findings showed that the patients need information regarding their physical activity , exercise patters, dietary pattern also and women’s are experiencing post operative complications also. The study concluded that the unmet needs of information may lead to patient’s distress.

Schroy pc et al (2008) conducted an experimental study to assess the effectiveness of educational strategy for improving the knowledge , risk perception and risk communication at the time of discharge among 315 adenoma patients in U. S. A. The computer based education programme was administered for 99 patients , standard care for 20 patients, personalized letter for 99 patients. The study findings showed that the computer based education program was more effective at the time of discharge at p <0. 05

Hendrix et al (2009) conducted an experimental study to determine the effectiveness of individualized care giver instruction for home care and symptom management conducted at the bedside of patients with cancer prior to hospital discharge among 49 patients at North Carolina. The questionnaire was administered at the end of the instruction to know about the usefulness of the instruction. The finding revealed that individualized bedside instruction to care giver before hospital discharge is effective at p> 0. 05 The study concluded that by giving instructions about symptom management and home care givers are very interested in participating the instruction.

Section-B : Reviews related to problems occurred at home after discharge

Osaba, D (2010) conducted a study on clinical trial experimental study on chemotherapy receiving clients in Italy. The aim of the study was to assess effect of post chemotherapy nausea and vomiting on health related quality of life in patients receiving chemotherapy. It was conducted among 832 chemotherapeutic patients; quality of life questionnaire was used to collect the data. The study found that, post chemotherapy induced nausea and vomiting adversely affect quality of life domains. But patients with only nausea experience less distribution than with both nausea and vomiting.

Booth, CM (2011) conducted a prospective study at Regional Cancer Center, Canada, to evaluate the chemotherapy induced nausea and vomiting in patients with breast cancer after discharge. The data were collected from 143 patients who received a total of 25 cycles of chemotherapy. The prevalence rates of nausea and vomiting were respectively, 37%and 13% at 24 hours and 70%and 15% during 2-5 days, severe emesis were reported by 25%of patients.

Beritbart. W (2011) conducted an experimental study at Weil Medical College Hospital among cancer patient to rule out the prevalence of cancer related fatigue . Fatigue is a common and highly distressing symptom of cancer associated with reduced quality of life and considerable psychological and functional morbidity. They reported prevalence of cancer related fatigue ranges from 4% to 91% depending on the specific cancer population studied and the method of assessment used, study results also showed that cancer related fatigue has typically been under reported, under diagnosed, and under treated.

Fan H. G et al (2012) conducted a follow up prospective controlled study at Margaret hospital Canada among breast cancer patient. The functional assessment of cancer treatment -general quality of life questionnaire, with subscales of fatigue and endocrine symptoms, and the high sensitivity cognitive screen was used. The study concluded that fatigue, menopausal symptoms and cognitive dysfunction were important adverse effects of chemotherapy.

Shaw J et al (2012) conducted a longitudinal study of family care givers role perception and supportive care needs. The aim of the study was to explore the experience of family caregivers of people diagnosed with upper GI cancer after surgical intervention among198 family care givers. The semi structured interviews were conducted and the finding showed that the family care givers had lack patient care knowledge . Family care giver view their roles as part of their family responsibility. The study concluded that the family members need education about the management of disease.

Hendrin et al (2010) conducted an experimental study to identify the influence of an individualized training on cancer caregiver’s self efficacy in home care and symptom management. The aim of the study was to investigate an individualized training to promote family care giver’s confidence in home care symptom management among 20 care givers in USA. The individualized training was conducted at the bedside prior to patient hospital discharge. The study result revealed that cancer care givers self efficacy measure increased by 41, 1 at one week follow up. The findings of the study suggested that individualized training improved self efficacy of care giver of cancer clients in home care management which enabled the cancer patients to stay longer in the comfort of their homes.

Ramdikshit et al (2008) conducted a survey to assess the incidence of constipation in oncological patients after getting discharge from the hospital among 99 patients in delhi and conducted a survey among the discharged patients. The findings showed that complications are occurring due to constipation such as intestinal obstruction, urinary dysfunction, anorexia, nausea and vomiting etc. From the patients perception identified that health education is needed to both the patient and the care giver before getting discharge to resolve the problems. The study concluded that if the patient and care giver can identify the appearance of constipation, its causes and symptoms by giving proper education can manage the symptoms.

Vanden et al (2009) conducted a prospective study to assess the quality of life during the first 3 months following discharge after surgery for head and neck cancer among 90 patients in Nether Lands . The quality of life questionnaire was administered. The study findings showed that the patients physical self efficacy was worsened and have poor quality life due to unawareness of the management of the disease process. The study concluded that if is possible to identify the patients with poor quality of life. The health care provider can plan patient rehabilitation program and can provide education to the care giver.

Morrison et al (2009) conducted an experimental study to assess the level of knowledge of oncology nurse about the management of quality of care and the cancer related diarrhea instruction at the time of discharge among 69 nurses at Columbia university and the knowledge questionnaire was administered. The study findings revealed that nurse quality of care has to improve

Section-C : Reviews related to readmission to the hospital

Quing et al 2009) conducted an experimental study to assess the effectiveness of pre admission and post discharge education in reducing hospital readmission among10, 174 patients in China. The education was given through telephone to the patients. The study concluded that the post discharge education to the patients reduce readmission following hospital discharge

Calskan et al (2010) conducted a quasi experimental study to assess the effectiveness of discharge planning program for cancer patients among 49 patients. For the experimental group discharge planning, discharge teaching, home visits and telephone consultation were provided and for the control group hospital routine was provided. The study findings revealed that there is decrease in the readmission of the patient to the hospital and higher satisfaction for the experimental group. The study concluded that the discharge planning program had a very significant effect on the care needs of patients.

Steve et al (2012), conducted a descriptive study to assess the mobility rate after hospital discharge and the readmission rate in older cancer patients(n= 111) in USA. The study result showed that 13 participants were readmitted within 30 days of discharge. There was a significant association between daily mobility and readmission rate. Study concluded that post discharge education on early mobility reduces the readmission rate.

Bernard et al (2009), conducted a prospective study to assess the readmission rate due to chemotherapy induced nausea and vomiting among 134 patients in Germany. Data were obtained from chart reviews and self administered patient questionnaire. The study findings revealed that 60. 7% patients reported readmission related to chemotherapy induced nausea and vomiting due to improper knowledge about the home care management of chemotherapy induced complications. Study concluded that discharge education on home care management on complication of chemotherapy has an impact on reducing readmission rate.

Foley. F. F et al (2009) conducted a prospective study to assess the readmission rate due to wound infection after colorectal resection among 176 patients in Virginia. Data were collected from intradepartmental surgical infection data base. The study findings revealed that the readmission due to wound infection was about 49%. Increase in body mass index and poor wound site management were found to be the cause for wound infection. The study concluded that instruction related to wound management is important before discharge.

Felipe et al (2009), conducted a prospective study to assess surgical site infection incidence among women (n= 354) who were discharged after breast cancer surgery in Brazil. Study result identified that the readmission rate after breast cancer surgery was 83% due to skin flap necrosis and bacterial colonization. Study concluded that the patients were unaware about the management of wound infection.

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