Transition of care: an evaluation of the role of the discharge liaison nurse in The Netherlands.

Problems in the transition of care from hospital to the home situation have led to the introduction of the discharge liaison nurse role in the Netherlands. A nation-wide hospital survey was carried out to gain insight into the role and function of discharge professionals. It was found that 56 of the 117 hospitals in the Netherlands (48%) have a special discharge professional. The discharge professional is a relatively new concept. On average it covers a full-time position. The function differs greatly between hospitals. Three working profiles can be distinguished: the organizational type, the advisory type and the policy-making type. In most cases the discharge professional is a nurse from a community agency based in the hospital and therefore best fits the description of a discharge liaison nurse. Of the 56 hospital-based initiatives involving discharge professionals, 11 (20%) have been systematically evaluated. A critical review of these evaluation studies showed a positive outcome on some aspects of quality of care, but no results were given on efficiency aspects. There was general appreciation of the discharge liaison nurse and continuation of the function was widely recommended. The quality of the evaluation studies was rather poor, and it is suggested that more substantial research should be carried out on this relatively new function.

Home visits by community nurses for cancer patients after discharge from hospital: an evaluation study of the continuity visit.

After discharge from the hospital, patients with cancer can have several problems at home. In this project, patients with cancer, who at time of discharge from the hospital were not indicated for nursing care at home, were offered three home visits by a community nurse. A prospective, descriptive study was undertaken to assess indicators of usefulness of these "continuity visits." It was registered how many and what patients [sex, age, (time of) diagnosis, social support, therapy] wanted to receive the visit. Care needs, as mentioned by the patients during the continuity visits, were reported after the visit by the community nurse. Both patients and community nurses completed an evaluation form after the first visit. A continuity visit was offered to 337 patients; 112 patients received a first, 50 a second, and 24 a third continuity visit. Older patients, patients without social support, and those diagnosed less than half a year before more often agreed to received a first visit. Reasons for patients not receiving a second or third visit were either that patients did not want one or on the contrary they were in need of immediate nursing care or had died before the visit. Two weeks after discharge, 93% of the patients experienced one or more physical, psychological, or social problems; 70% mentioned a need for information; and 47% needed emotional support. Both patients and community nurses evaluate the first visit positively. The findings suggest that continuation of the offer of the first continuity visit could be useful.

[Initial experiences with home care for peritoneal dialysis rendered by district nurses]. / Eerste ervaringen met thuiszorg voor peritoneale dialyse door de wijkverpleging.

OBJECTIVE: To investigate the feasibility of home care for continuous ambulatory peritoneal dialysis (CAPD) by district nurses. DESIGN: Descriptive study. SETTING: Free University Hospital in Amsterdam. PATIENTS: Patients with end-stage renal disease who were eligible for CAPD but were not able to carry out the CAPD treatment themselves were given assistance by district nurses. During the study period from December 1991 to December 1992 the patients' clinical scores were recorded every 3 months, and questionnaires were sent to both the district and the hospital nurses. RESULTS: During the study period 58 months of CAPD home care were given to ten patients (average age 74 years) by 159 community nurses. These had received a preliminary training by the staff of the dialysis department and they were supported by consultation. Three patients died during the study period. Five patients continued the CAPD home care treatment after December 1992. CONCLUSION: CAPD home care by district nurses is feasible on the following conditions: extra financing, preliminary training and support for the district nurses from the hospital staff by consultation.

[Risks of the IUD for young women]. / Risico's van het IUD voor jonge vrouwen.

PIP: IUDs were inserted in 523 young nulligravidae in a family planning clinic. 466 of them were kept under regular observation for 12 months. In 78.5% of the cases, the IUD was still in situ 12 months following insertion. In 18.5%, medical reasons necessitated removal. The probability that an IUD will have to be removed and the risk of IUD expulsion are higher in women under age 20. Pelvic inflammatory disease (PID) occurred in 12 women (2.5%), in 8 of them within 8 weeks postinsertion; in 6 cases (1%), this necessitated hospitalization. In the population examined, PID was found to have a statistically significantly higher incidence among women with different sex partners. Ascending infections do not occur more frequently in young women or in nulligravidae than in other women. (author's modified)^ieng