Describing Transfers Originating Out-of-Facility for Nursing Home Residents.
Hanna T Webb, Kristi M Lieb, Timothy E Stump and 2 others
PMID 34181908WHAT IT FOUND
Nursing home residents transferred after leaving the facility were younger, less cognitively impaired, and more often had cardiovascular symptoms, especially from dialysis.
Nurses should expect communication gaps and check advance care plans before outside visits.
Key findings
01Community transfers were more likely to be for cardiovascular-related illness (31.2% vs 8.7%, p = 0.014).
02Nearly half (46%) of transfers outside the nursing home originated from dialysis centers.
03RNs identified communication issues as an opportunity for improvement in 25.6% of transfers originating outside the nursing home.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 82 community transfers were analysed, so comparisons with direct transfers had limited precision. Project RNs judged avoidability using clinical judgment after the event, not an independent measure of whether the transfer could have been prevented. Data came from 19 nursing homes in central Indiana participating in OPTIMISTIC, and Hispanic residents made up only 0.8% of all transfers, so results may not apply to other settings. The study did not follow outcomes after transfer, so it cannot show whether better communication or advance care planning reduced admissions or harm.
Declared interests
The paper is listed as receiving NIH extramural and U.S. government non-PHS support. One author is the former CEO and founder of Probari, a business intended to disseminate the OPTIMISTIC model. All other authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that community transfers were more avoidable or that cardiovascular symptoms caused them. RNs judged 27.5% of community transfers and 24.5% of direct transfers avoidable, and the study did not test an intervention that reduced transfers.