Perceived Readiness for Hospital Discharge in Adult Medical-Surgical Patients

PURPOSE: The purpose of the study was to identify predictors and outcomes of adult medical-surgical patients' perceptions of their readiness for hospital discharge. DESIGN: A correlational, prospective, longitudinal design with path analyses was used to explore relationships among transition theory-related variables. SETTING: Midwestern tertiary medical center. SAMPLE: 147 adult medical-surgical patients. METHODS: Predictor variables included patient characteristics, hospitalization factors, and nursing practices that were measured prior to hospital discharge using a study enrollment form, the Quality of Discharge Teaching Scale, and the Care Coordination Scale. Discharge readiness was measured using the Readiness for Hospital Discharge Scale administered within 4 hours prior to discharge. Outcomes were measured 3 weeks postdischarge with the Post-Discharge Coping Difficulty Scale and self-reported utilization of health services. FINDINGS: Living alone, discharge teaching (amount of content received and nurses' skill in teaching delivery), and care coordination explained 51% of readiness for discharge score variance. Patient age and discharge readiness explained 16% of variance in postdischarge coping difficulty. Greater readiness for discharge was predictive of fewer readmissions. CONCLUSIONS: Quality of the delivery of discharge teaching was the strongest predictor of discharge readiness. Study results provided support for Meleis' transitions theory as a useful model for conceptualizing and investigating the discharge transition. IMPLICATIONS FOR PRACTICE: The study results have implications for the CNS role in patient and staff education, system building for the postdischarge transition, and measurement of clinical care outcomes.