Responsible hospital discharge: content validation of nurse’s activities

Content validation study. The 14 generated items were organized on a Likert scale and submitted to judges’ appreciation, using the Delphi Technique. Relevance, explicitness in the statements and the sequential order of execution were evaluated. The consensus for the answers was pre-established at 0.80 and the content validity index was calculated.

Results:

Eight professionals participated in the validation of the created list. In Delphi 1, the content validity index ranged from 0.7 (post-discharge contact and home visit scheduling) to 1.0 and in Delphi 2, a range from 0.60 (post-discharge telephone contact) to 1.0.

Conclusion:

13 of the 14 proposed activities were validated. The created list of activities can contribute to the safe discharge process, the continuity and comprehensiveness of care and, also, to the reduction of readmissions.

Keywords:
Patient discharge; Continuity of patient care; Process assessment, health care; Nursing assessment; Validation study

Activities	M	SD	Md	Q1	Q3
1. Eligibility Criteria	4.0	0.0	4.0	4.0	4.0
2. Medical contact and discharge forecast	3.9	0.3	4.0	4.0	4.0
3. Therapeutic project	3.9	0.3	4.0	4.0	4.0
4. Information collection	4.0	0.0	4.0	4.0	4.0
5. Elaboration of discharge plan	3.6	0.7	4.0	3.5	4.0
6. Patient/family communication	4.0	0.0	4.0	4.0	4.0
7. Professional team coordination	3.7	0.5	4.0	3.5	4.0
8. Documentation and referrals	3.7	0.5	4.0	3.5	4.0
9. Information sharing	3.7	0.5	4.0	3.5	4.0
10. Patient/family guidance	3.9	0.3	4.0	4.0	4.0
11. Teaching of equipment handling	4.0	0.0	4.0	4.0	4.0
12. Post-discharge contact	3.2	0.9	3.5	2.5	4.0
13. Scheduling home visit	3.2	1.2	4.0	2.5	4.0
14. Discharge Plan Effectiveness	3.6	0.7	4.0	3.5	4.0

Activities	pc	I-CVI	K^*
1. Eligibility criteria	0.004	1.00	1.00
2. Medical contact and discharge forecast	0.004	1.00	1.00
3. Therapeutic project	0.004	1.00	1.00
4. Information collection	0.004	1.00	1.00
5. Elaboration of discharge plan	0.031	0.87	0.87
6. Patient/family communication	0.004	1.00	1.00
7. Professional team coordination	0.004	1.00	1.00
8. Documentation and referrals	0.004	1.00	1.00
9. Information sharing	0.004	1.00	1.00
10. Patient/family guidance	0.004	1.00	1.00
11. Teaching of equipment handling	0.004	1.00	1.00
12. Post-discharge contact	0.109	0.75	0.72
13. Scheduling home visit	0.109	0.75	0.72
14. Discharge Plan Effectiveness	0.031	0.87	0.87

Activities	M	SD	Md	Q1	Q3
1. Eligibility criteria	3.8	0.4	4.0	4.0	4.0
2. Medical contact and discharge forecast	4.0	0.0	4.0	4.0	4.0
3. Therapeutic project	4.0	0.0	4.0	4.0	4.0
4. Information collection	3.6	0.5	4.0	3.0	4.0
5. Patient/family communication	4.0	0.0	4.0	4.0	4.0
6. Elaboration of discharge plan	3.8	0.4	4.0	4.0	4.0
7. Professional team coordination	4.0	0.0	4.0	4.0	4.0
8. Documentation and referrals	3.8	0.4	4.0	4.0	4.0
9. Information sharing	3.6	0.5	4.0	3.0	4.0
10. Patient/family guidance	4.0	0.0	4.0	4.0	4.0
11. Teaching of equipment handling	3.8	0.4	4.0	4.0	4.0
12. Telephone contact after discharge (up to 7 days)	2.8	0.8	3.0	2.0	3.0
13. Scheduling home visit ^*	4.0	0.0	4.0	4.0	4.0
14. Identification/solving post-discharge problems	3.8	0.4	4.0	4.0	4.0

Activities	pc	I-CVI	K^*
1. Eligibility criteria	0.031	1.00	1.00
2. Medical contact and discharge forecast	0.031	1.00	1.00
3. Therapeutic project	0.031	1.00	1.00
4. Information collection	0.031	1.00	1.00
5. Patient/family communication	0.031	1.00	1.00
6. Elaboration of discharge plan	0.031	1.00	1.00
7. Professional team coordination	0.031	1.00	1.00
8. Documentation and referrals	0.031	1.00	1.00
9. Information sharing	0.031	1.00	1.00
10. Patient/family guidance	0.031	1.00	1.00
11. Teaching of equipment handling	0.031	1.00	1.00
12. Telephone contact after discharge (up to 7 days)	0.313	0.60	0.42
13. Scheduling home visit ^*	0.031	1.00	1.00
14. Identification/solving post-discharge problems	0.031	1.00	1.00

ACTIVITIES
1	To identify eligibility criteria for responsible discharge of the patient through active bedside search.
2	To discuss with the physician the hospital discharge forecast.
3	To establish the therapeutic project and the discharge plan with the multidisciplinary team.
4	To collect information from the patient (main caregiver, health care network in the municipality, clinical conditions, family composition, and necessary care at home, among others), facilitating and restricting factors for continuing care at home.
5	To communicate and involve the patient and/or family member/caregiver in the discharge plan.
6	To elaborate the discharge plan and its documentation in medical records or electronically.
7	To align the communication process and coordinate actions between the multidisciplinary team.
8	To document the necessary referrals, reference and counter-reference guide, home oxygen process and others for the social worker.
9	To share information with the city of origin related to clinical conditions, care, family nucleus, among other information relevant to the process.
10	To guide the patient and family/caregiver about the necessary care and measures after hospital discharge, verbally and/or in writing.
11	To teach the patient and family member/caregiver how to handle equipment and/or special materials for the necessary care at home, reviewing and certifying their understanding.
12	To schedule and conduct home visits for patients with greater demand for care needs (use of equipment/devices or care with greater technical complexity).
13	To identify problems after hospital discharge, by telephone or on a home visit, and establish a care plan to resolve them, involving the primary care unit of reference, when necessary.

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author:
Marcia Galan Perroca E-mail: marcia.perroca@gmail.com