HsiuHsin Tsai
Chang Gung University, Taiwan
Title: Development, validation and testing of a nursing home to emergency room transfer checklist
Biography
Biography: HsiuHsin Tsai
Abstract
Aims and objectives. To develop, validate and test an instrument to support patients’ nursing home to emergency room transfer (NHERT).
Background. Transfers from a nursing home care facility to an acute care facility such as a hospital emergency room are common. However, the prevalence of an information gap for transferring residents’ health data to acute care facility is high. An evidenced based transfer instrument, which could fill this gap, is lacking.
Design. Development of a NHERT checklist, validation of items using the Delphi method, and criterion-related validity to test the instrument.
Methods. Items were developed based on qualitative data from previous research. Delphi validation, retrospective chart-review (baseline data), and a 6-month prospective study design were applied to test the validity of the instrument. Variables for criterion-related validity included residents’ 30 days readmission rate and length of hospital stay.
Results. Development of the NHERT checklist resulted in four main parts: 1) demographic data of the NH resident, 2) critical data for nursing home to emergency room transfer, 3) contact information, and 4) critical data for ER to NH transfer. Two rounds of Delphi validation resulted in a mean score (standard deviation) ranging from 4.39 (1.13) to 4.98 (.15). Time required to complete the scale was 3-5 minutes. Use of the NHERT checklist resulted in a 30-day readmission rate of 13.4%, which was lower than the baseline rate of 15.9%.
Conclusions. The NHERT checklist was developed for transferring nursing home residents to an emergency room. The instrument was found to be a valid tool.
Relevance to clinical practice. Use of the NHERT checklist for nursing home transfers could fill the information gap that exists when transferring older adults between facilities such as nursing homes and hospitals.