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Emergency department nurses' experience of implementing discharge planning for emergency department patients in Taiwan : a phenomenographic study

Han, Chin-Yen (2008) Emergency department nurses' experience of implementing discharge planning for emergency department patients in Taiwan : a phenomenographic study. PhD by Publication, Queensland University of Technology.

Abstract

During recent reforms to the Taiwanese health care system, discharge planning for hospital patients has become an issue of great concern as a result of shorter hospital stays, increased health care costs and a greater emphasis on community care. There are around five million patients visiting in emergency departments (ED) per year in Taiwan with up to 85% of these, 4,250,000 emergency patients, discharged directly from the emergency department. This significant number of ED visits highlights the need to implement discharge planning in the ED. ED nurses are not only responsible for providing appropriate assessments of a patient's future care needs but also for implementing effective discharge planning as a legal obligation; discharge planning is also a patient's right in Taiwan. For ED nurses to function effectively in the role of discharge planner, it is important that they have a comprehensive understanding of implementing discharge planning. To date, no published research focuses on nurses' experience of implementing discharge planning in the ED in Taiwan. This study is the first step in identifying the experience and understanding of nurses in implementing discharge planning in the ED in Taiwan and may have implications worldwide.

The purpose of this study was to identify and describe the experience and understanding of the qualitatively different ways in which ED nurses’ experience of implementing discharge planning for emergency patients in Taiwan. In order to identify and describe the experience of implementing discharge planning, the qualitative approach of a phenomenography was chosen. Thirty-two ED nurses in Taiwan who matched the participant selection criteria were asked to describe their experience and understanding of the implementation of discharge planning in the ED. Semi-structured interviews were audio-taped and later transcribed verbatim. The data analysis process focused on identifying and describing ways ED nurses’ experience and understanding of implementing discharge planning in the ED. There were two major outcomes of this study: six categories of description and an outcome space. These six categories of description revealed the experience and understanding of implementing discharge planning in the ED. An outcome space portraying the logical relations between the categories of description was identified.

The six categories of description were implementing discharge planning as ‘getting rid of my patients’; implementing discharge planning as completing routines; implementing discharge planning as being involved in patient education; implementing discharge planning as professional accountability; implementing discharge planning as autonomous practice; implementing discharge planning as demonstrating professional nursing care in ED. The outcome space mapped the three levels of hierarchical relationship between these six categories of description. The referential meaning of implementing discharge planning was the commitment to providing discharge services in the ED.

The results of this research contribute to describing the nurses’ experience in the implementation of the discharge planning process in the emergency nursing field, in order to provide accurate and effective care to patients discharged from the ED. This study also highlights key insights into the provision of discharge services both in Taiwan and World-wide.

Impact and interest:

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ID Code: 17003
Item Type: QUT Thesis (PhD by Publication)
Supervisor: Barnard, Alan, Chapman, Helen, & Kellett, Ursula
Keywords: emergency department, hospitals, nursing, Taiwan
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Nursing
Institution: Queensland University of Technology
Deposited On: 17 Dec 2008 16:03
Last Modified: 29 Oct 2011 05:51

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