Estratégias de transição para alta hospitalar utilizadas por enfermeiros: revisão integrativa
DOI:
https://doi.org/10.5902/2179769264383Palavras-chave:
Enfermeiros, Cuidado transicional, Continuidade da assistência ao paciente, Alta do paciente, EstratégiasResumo
Objetivo: identificar estratégias de transição do cuidado na alta hospitalar, utilizadas por enfermeiros para o fortalecimento da continuidade do cuidado, disponíveis na literatura científica. Método: revisão integrativa da literatura, que incluiu estudos completos, tendo como referência as estratégias "care transition" OR "Continuity of Patient Care" OR "care continuity" AND nurse para as bases de dados BVS, PubMed, SCOPUS e WoS e "care transition" OR "care continuity" AND nurse para CINAHL, publicados em inglês, espanhol ou português, entre 2016 e 2020, que responderam à questão de revisão. Resultados: foram selecionados 23 artigos, e as estratégias de transição do cuidado para a alta hospitalar usadas por enfermeiros para o fortalecimento do cuidado foram educação em saúde, reconciliação medicamentosa, telemonitoramento, planejamento da alta, contrarreferência e visita domiciliar. Conclusão: o enfermeiro é responsável pelo desenvolvimento de estratégias de transição interconectadas para o fortalecimento do cuidado, desenvolvendo ações diversificadas que qualificam a atenção.
Downloads
Referências
Mendes FRP, Gemito MLGP, Caldeira EC, Serra IC, Casas-Novas MV. A continuidade de cuidados de saúde na perspectiva dos utentes. Ciênc Saúde Colet. 2017;22(3):841-53. doi: 10.1590/1413-81232017223.26292015
Cunha EM, Giovanella L. Longitudinality/continuity of care: identifying dimensions and variables to the evaluation of Primary Health Care in the context of the Brazilian public health system. Ciênc Saúde Colet. 2011;6(Suppl 1):1029-42. doi: 10.1590/S1413-81232011000700036
Vargas I, Garcia-Subirats I, Mogollón-Pérez AS, Paepe PD, Silva MRF, Unger JP, et al. Patient perceptions of continuity of health care and associated factors. Cross-sectional study in municipalities of central Colombia and North-eastern Brazil. Health Policy Plan. 2017;32(4):549-62. doi: 10.1093/heapol/czw168
Acosta AM, Câmara CE, Weber LAF, Fontenele RM. Nurse´s activities in care transition: realities and challenges. Rev Enferm UFPE On Line. 2018;12(12):3190-7. doi: 10.5205/1981-8963-v12i12a231432p3190-3197-2018
Carr DD. High-Quality care transitions promote continuity of care and safer discharges. J N Y State Nurses Assoc [Internet]. 2019 [cited from 2021 Feb 05];46(2):4-9. Available from: https://issuu.com/nystatenursesassociation/docs/nysnajournalv46no2/s/10321671
Spall HC, Rahman T, Mytton O, Ramasundarahettige C, Ibrahim Q, Kabali M, et al. Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Eur J Heart Fail. 2017;19(11):1427-43. doi: 10.1002/ejhf.765
Weber LAF, Lima MADS, Acosta AM, Marques GQ. Care transition from hospital to home: integrative review. Cogitare Enferm. 2017;22(3):e47615. doi: 10.5380/ce.v22i3.47615
Ribas EDN, Bernardino E, Larocca LM, Poli PP, Aued GK, Silva CPC. Nurse liaison: a strategy for counter-referral. Rev Bras Enferm. 2018;71(Suppl 1):546-53. doi: 10.1590/0034-7167-2017-0490
Ganong LH. Integrative reviews of nursing research. Res Nurs Health. 1987;10(1):1-11. doi: 10.1002/nur.4770100103
Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2011.
Bikmoradi A, Masmouei B, Ghomeisi M, Roshnaei G. Impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft surgery: a quasi-experimental study in Iran. Int J Med Inform. 2016;86:43-8. doi: 10.1016/j.ijmedinf.2015.12.001
Moyer A, McGillen B. Transitioning Patients Across the Care Continuum. Nurse Lead. 2018;16(6):389-92. doi: 10.1016 / j.mnl.2018.07.011
Ong MK, Romano PS, Edginton S, Aronow HU, Auerbach AD, Black JT, et al. Effectiveness of remote patient monitoring after discharge of hospitalized patients With heart failure: The Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized clinical trial. JAMA Intern Med. 2016. 176(3):310-8. doi: 10.1001/jamainternmed.2015.7712
Phelps P, Sutton K. Structured telephonic consultation to decrease heart failure readmissions. Medsurg Nurs [Internet]. 2018 [cited 2021 Feb 05];27(3):153-72. Available from: https://www.proquest.com/openview/be0aa8f01d43d82fabe75f0db9287b5f/1?pq-origsite=gscholar&cbl=30764
Ruggiri JC, Milner KA, Buonocore D. Implementing post-discharge 48-hour scripted call for patients with heart failure: an evidence-based practice quality improvement project. Medsurg Nurs [Internet]. 2019 [cited 2021 Feb 05];28(3):183-7. Available from: https://www.proquest.com/openview/40722d1745ed79b1ea423e02a0115dbe/1?pq-origsite=gscholar&cbl=30764
Smith J, Pan DM, Novelli MA. Nurse practitioner-led intervention to reduce hospital readmissions. J Nurse Pract. 2016;12(5):311-6. doi: 10.1016/j.nurpra.2015.11.020
Biese KJ, Busby-Whitehead J, Cai J, Stearns SC, Roberts E, Milhas P, et al. Telephone follow-up for older adults discharged to home from the emergency department: a pragmatic randomized controlled trial. J Am Geriatr Soc. 2018;66(3):452-8. doi: 10.1111/jgs.15142
Dizon ML, Reinking C. Reducing readmissions: nurse-driven interventions in the transition of care from the hospital. Worldviews Evid Based Nurs. 2017;14(6):432-9. doi: 10.1111/wvn.12260
Knight SW, Trinkle J, Tschnnen D. Hospital-to-homecare videoconference handoff: improved communication, coordination of care, and patient/family engagement. Home Healthc Now. 2019;37(4):198-207. doi: 10.1097/NHH.0000000000000755
Kripalani S, Chen G, Ciampa P, Theobald C, Cao A, McBride M, et al. A transition care coordinator model reduces hospital readmissions and costs. Contemp Clin Trials. 2019;81:55-61. doi: 10.1016/j.cct.2019.04.014
Radhakrishnan K, Jones TL, Weems D, Knight TW, Rice WH. Seamless transitions: achieving patient safety through communication and collaboration. J Patient Saf. 2018;14(1):e3-5. doi: 10.1097/PTS.0000000000000168
Ritchie CS, Houston TK, Richman JS, Sobko HJ, Berner ES, Taylor BB, et al. The E-Coach technology-assisted care transition system: a pragmatic randomized trial. Transl Behav Med. 2016;6(3):428-37. doi: 10.1007/s13142-016-0422-8
Spall HGC, Lee SF, Xie F, Oz UE, Perez R, Mitoff PR, et al. Effect of patient-centered transitional care services on clinical outcomes in patients hospitalized for heart failure: the PACT-HF randomized clinical trial. JAMA. 2019;321(8):753-61. doi: 10.1001/jama.2019.0710
Yatim F, Cristofalo P, Ferrua M, Girault A, Lacaze M, Palma MD, et al. Analysis of nurse navigators’ activities for hospital discharge coordination: a mixed method study for the case of cancer patients. Support Care Cancer. 2017;25(3):863-8. doi: 10.1007/s00520-016-3474-x
Hardiman KM, Reames CD, Mcleod MC, Regenbogen SE. Patient autonomy-centered self-care checklist reduces hospital readmissions after ileostomy creation. Surgery. 2016;160(5):1302-8. doi: 10.1016/j.surg.2016.05.007
Hewnwe S, Sullivan SS, Yu G. Reducing emergency room visits and in-hospitalizations by implementing best practice for transitional care using innovative technology and big data. Worldviews Evid Based Nurs. 2018;15(3):170-7. doi: 10.1111/wvn.12286
Anronoff MB, Ragalie W, Correa AM, Spicer JD, Sepesi B, Roth JA, et al. Results of postdischarge nursing telephone assessments: persistent symptoms common among pulmonary resection patients. Ann Thorac Surg. 2016;102(1):276-81. doi: 10.1016/j.athoracsur.2016.01.062
Aued GK, Bernardino E, Lapierre J, Dallaire C. Liaison nurse activities at hospital discherge: a strategy for continuity of care. Rev Latinoam Enferm. 2019;27:e3162. doi: 10.1590/1518-8345.3069-3162
Auger KA, Shah SS, Tubbs-Cooley HL, Sucharew HJ, Gold JM, Wade-Murphy S, et al. Effects of a 1-Time nurse-led telephone call after pediatric discharge: the H2O II randomized clinical trial. JAMA Pediatr. 2018;172(9):e181482. doi: doi: 10.1001/jamapediatrics.2018.1482
Hastings SN, Stechuchak KM, Coffman CJ, Mahanna EP, Weunberger M, Houtven CHV, et al. Discharge information and support for patients discharged from the emergency department: results from a randomized controlled trial. J Gen Intern Med. 2020;35(1):79-86. doi: 10.1007/s11606-019-05319-6
Pacho C, Domingo M, Núñez R, Lupón J, Moliner P, Antonio A, et al. Una consulta específica al alta (STOP-HF-Clinic) reduce los reingresos a 30 días de los pacientes ancianos y frágiles con insuficiencia cardiaca. Rev Esp Cardiol. 2017;70(8):631-8. doi: 10.1016/j.recesp.2016.12.026
Ribas EN, Bernardino E, Larocca LM, Poli Neto P, Aued GK, Silva CPC. Nurse liaison: a strategy for counter-referral. Rev Bras Enferm. 2018;71(Suppl 1):546-53. doi: 10.1590/0034-7167-2017-0490
Wells S, O'Neill M, Rogers J, Blaine K, Hoffman A, McBride S, et al. Nursing-led home visits post-hospitalization for children with medical complexity. J Pediatr Nurs. 2017;34:10-6. doi: 10.1016/j.pedn.2017.03.003
Ministério da Saúde (BR), Secretaria de Gestão do Trabalho e da Educação na Saúde, Departamento de Gestão e da Regulação do Trabalho em Saúde. Câmara de Regulação do Trabalho em Saúde. Brasília (DF): Ministério da Saúde; 2006.
World Health Organization (WHO). Medication without harm: WHO global patient safety challenge [Internet]. Geneva (CH): WHO; 2017 [cited 2021 Feb 05]. Available from: http://apps.who.int/iris/bitstream/10665/255263/1/WHO-HIS-SDS-2017.6- eng.pdf?ua=1
Lemos DMP, Saldanha PF, Vieira LF, Azzolin KO. Nursing taxonomies in hospital discharge planning: a quasi-experimental study. Rev Bras Enferm. 2020;73(5):e20180896. doi: 10.1590/0034-7167-2018-0896
Cunha LP, Silva FVC, Santos FK, Pires AS, Leone DRR, Silva LCS. The home visit in peritoneal dialysis: relevant aspects to nursing care. Rev Pesq Cuid Fundam. 2017;9(1):128-36. doi: 10.9789/2175-5361.2017.v9i1.128-136
Lombardi NF, Mendes AEM, Lucchetta RC, Reis WCT, Fávero MLD, Correr CJ. Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study. Rev Latinoam Enferm. 2016;24:e2760. doi: 10.1590/1518-8345.0820.2760
Jackson, ML. Transitional care: methods and processes for transitioning older adults with cancer in a postacute settin. Clin J Oncology Nurs. 2018;22(6):37-41. doi: 10.1188/18.CJON.S2.37-41
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Este trabalho está licenciado sob uma Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
