Nurses' attitudes toward the transfer of nursing home patients to the hospital

Abstract

Nurses general and specific attitudes toward transfer of nursing home patients to the hospital were examined as a secondary analysis of a larger study of hospitalization of nursing home patients. The central aim of this analysis was to assess and predict statistically nurses attitude toward transfer in relation to patient characteristics (i.e., primary diagnosis, level of care, pre transfer health and mental status, and behavior), staff shift and nursing home facility/capability problems (i.e., staffing problems, need intravenous therapy, and diagnostics).;The sample consisted of 108 nurse informants and 229 nursing home patients who were transferred to the hospital and returned. Descriptive, Bivariate (zero-order correlations), and Multivariate (Hierarchical Regression) analyses were conducted.;Trauma as a primary diagnosis (e.g., hip fracture) accounted for 9% of the transfers and was associated with nurses feeling the transfer was necessary (r =.13) and that these patients were adversely affected by the transfer (r =.32).;Fever and vomiting was also associated with nurses perceiving the transfer was necessary (r =.11). However, those patients transferred for infection (32%), fever, and vomiting were felt not to be adversely affected by the transfer (r = {dollar}-{dollar}.14).;In general, nurses, believed transfer was unnecessary for patients who were physically frail and poorly oriented, and a negative experience for patients who were cognitively and behaviorally impaired.;There was an association between feeling the transfer was unnecessary and the need for intravenous therapy (r =.15). There was also a relationship between feeling negatively toward transfer in general and "facility resource problems" as non-medical considerations for transfer (i.e., staff problems r =.16). Ninety-three percent of the nurse informants felt that with proper facilities and equipment within the nursing home transfer would not have to take place at least some of the time.;Overall, the results suggested that nurses involved in hospital transfer felt the following: hospital transfer has deleterious effects on patients, hospital transfer would be unnecessary if proper equipment and facilities were available, but given current resources, transfer to the hospital is necessary.