Nurses' discharge planning and risk assessment: behaviours, understanding and barriers

AIMS AND OBJECTIVES: To examine nurses' discharge planning understanding, adherence and barriers. BACKGROUND: Discharge planning commenced at admission by nurses plays a key role in improving patient outcomes,but policies in place to maintain effective discharge planning are often not followed by nurses. DESIGN: This is a descriptive study. METHODS: Nurses (n = 64) working in acute wards undertook a self-report survey of discharge planning understanding, adherence and barriers. RESULTS: Adherence to discharge planning policy is low (23%), despite a general awareness of the reduced quality of patient outcomes that may result. The most common barriers to discharge planning identified were lack of time and patient factors. Further contradictions occurred in that nurses understood the importance of discharge planning, yet did not comply with discharge planning policies. CONCLUSIONS: Nurses require additional encouragement and support in complying with discharge planning policies, and discharge planning policies should be adapted to better handle unpredictable illness trajectories. RELEVANCE TO CLINICAL PRACTICE: Completion of discharge planning is important for the safe transition of patients from one care setting to the next. Before a systematic approach to discharge planning can be implemented, a greater understanding of nurses' discharge planning practice in acute care wards is required. Greater incorporation of discharge planning activities into nurses' daily practice may also occur if nurses are involved in the development and implementation of the discharge processes and then provided with education and regular feedback on monthly audit results.