| Summary: | 碩士 === 輔英科技大學 === 護理系碩士班 === 101 === Discharge planning is a service catered to the needs of patients after discharge, and therefore, patients’ needs assessment is a critical factor in successfully planning for discharge. This study is aimed at exploring the effectiveness of using a systematic assessment tool for hospital discharge planning. The research adopted a longitudinal two-group comparison study design, and for the convenience of sampling, research was conducted at eight wards in a regional teaching hospital in southern Taiwan. The study subjects were selected from the patients who had the needs of discharge planning service. Between October 2012 and December 2012, the patients were subject to using a discharge planning sheet, a traditional assessment tool used for the planning of discharge, , while between January 2013 to April 2013, the patients were subject to the use of patients’ needs ranking evaluation chart for discharge planning, a systematic assessment tool to plan for discharge,. Sixty-eight patients were then paired up with similar age and ADL score level, and the two matched groups were named as “the group using the traditional assessment tool” and “the group using the systematic assessment tool”, respectively.
Research tools included medical records, the questionnaire of care needs and service satisfaction levels for the planning of discharge by primary decision-makers, and case managers’ satisfaction levels on the use of evaluation tools. The software SPSS 12.0 was used for statistical analysis, including descriptive statistical analysis on frequency, percentage, mean and standard deviation, and McNemar’s chi-square test, Bowker’s chi-square test and paired samples t-test. Statistical significance is found where p < .05.
The study results showed that the demographics for the two groups and their primary decision-makers are statistically homogeneous. In terms of the integrity of the patients’ needs assessment and the placement appropriateness after discharge, the group using the systematic assessment tool had significantly higher assessment integrity and placement appropriateness; in addition, the group’s rate of readmission or mortality within 14 days after discharge was significantly lower. There was no statistical significance in the satisfaction differences of the clinical case managers or the primary decision-makers across the two groups. However, the differences in the satisfaction levels of three test items had effect sizes which are clinically significant. In addition, the differences in the number of days spent unnecessarily in the hospital, and the rate of referring to other medical professionals meeting needs showed no statistical significance. Based on the results, the researcher suggests that to meet the needs of the primary decision-makers and to increase their satisfaction level, and also to succeed in effective discharge planning, the systematic assessment tool should be used for assessing patients’ needs, and the hospital should also provide related facilities and assist in carrying out all plans effectively.
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