Comparison of Outcomes of Discharge Planning and Post-Discharge Follow-up Care, provided by Advanced Practice, Expert-by-experience, and Novice Nurses, to Hospitalized Elders with Chronic Healthcare Conditions

The objectives of this mixed methods study were to: compare the outcomes of discharge planning and follow-up care, for elders with chronic healthcare conditions, among an advanced practice nurse (APN), expert-by-experience nurses, and novice nurses who delivered care through a "Continuity of Care Program;" and, describe the benefits of APN care services from key stakeholders' (i.e., healthcare colleagues and family caregivers) perspectives. The outcomes of care, compared among the three type of nurse groups, at two-months post-discharge, included: patient outcomes (functional ability, pressure sores, urinary tract infections, pneumonia, acute confusion, and falls); hospital outcomes (emergency room visits, hospital readmission, time between hospital discharge and the first readmission, and length of re-hospitalization stay); and, family caregivers' satisfaction with nursing care. One hundred elderly patients and their respective family caregivers were recruited from the medical wards of a major university hospital in Bangkok, Thailand. Quantitative and qualitative data were collected, over 12 months, by way of nursing and medical records, questionnaires, and interviews. Quantitative data were analyzed using descriptive statistics, chi-square, one-way ANOVA, and the posthoc Tamhane test, whereas qualitative data were analyzed via content analysis. Even through the results revealed only family caregivers' satisfaction with nursing care was higher for the APN-directed care, compared to the care delivered by the novice and expert-by-experience nurses, benefits of APN practice were noted from the data obtained from key stakeholders.