Nursing home nurses seek hospital transfers guidance

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Lead researcher O’Neill: Pursue more education to strengthen your voice.
Lead researcher O’Neill: Pursue more education to strengthen your voice.

A comprehensive review of nursing homes nurses' perceptions about emergency room transfers shows nurses want more resources and more guidance to determine who goes and who stays.

Australian researchers reviewed seven qualitative studies to better understand why nurses face challenges navigating this complex decision.

Among the chief findings: Nurses sometimes lack fellow staff members or equipment that could prevent having to make a transfer, even tools as simple as suture kits of X-ray machines; nurses frequently feel pressured by families to convince a doctor about what the patient “needs”; and they often have negative expectations about their patients' care in hospital settings.

“Nursing home nurses appeared more confident and decisive when there was some kind of plan in place, whether it is a policy, procedure, advance directive, medical care plan, hospital avoidance program or informal plan of care,” wrote researchers in Geriatric Nursing. The team was headed by Barbara O'Neill, BSN, associate lecturer at Central Queensland University.

The researchers recommend nurses brush up on clinical skills to be attuned to signs of patient deterioration; establish opportunities to collaborate with hospital nurses; and review legal rights and responsibilities so they feel less pressure to transfer.