A Systematic Review of Interventions to Improve the Communication of Advanced Directives and Medication Administration Records for Elderly Patients Transferring Between Nursing Homes and Acute Care Hospitals
Public Deposited- Last Modified
- March 17, 2020
- Creator
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LaMantia, Michael A.
- Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
- Abstract
- Objectives: To conduct a systematic review of the literature to identify interventions that can improve the communication of advanced care directives and accurate and appropriate medication lists for elderly patients transferring between nursing homes and acute care hospitals. Methods: The MEDLINE, ISI, and EBSCO Host databases were searched from inception to February 17, 2008 for appropriate articles. All abstracts identified by a prespecified strategy were reviewed. Studies met inclusion criteria if their design was of a randomized control trial, pre/post observational trial, or post-intervention observational study. Data regarding each study were abstracted from the manuscript by the reviewer to a standardized collection instrument and details regarding type of study, study population, intervention, and results were recorded in evidence tables. Results: Six hundred ninety-six titles were identified by the pre-specified search strategies. Eighteen articles were submitted for full review. Thirteen articles did not meet inclusion/exclusion criteria and five articles were determined to describe interventions that resulted in the enhanced transition of appropriate medication lists or advanced directives between skilled nursing facilities and acute care hospital settings, whether to the emergency department or inpatient units. Of these articles, two articles described interventions that resulted in the enhanced transmission of advanced directives, two articles described interventions that resulted in the better transmission of medication lists, and one article described an intervention that accomplished both of these goals. Conclusions: The accurate communication of key patient information is integral to providing high quality health care to elderly, skilled nursing facility patients transferring to and from acute care hospitals. A standardized patient transfer document may assist with the successful communication of advanced care directives and medication lists, while a pharmacist-developed review of medication lists may help identify omitted or indicated medications on patient transfer. Randomized controlled trials with large number of patients in varied health care systems may be needed to determine the ideal design and medium for a patient transfer document. Further work will be needed to coordinate research efforts and adopt standardized definitions of high quality transitional care.
- Date of publication
- May 2008
- DOI
- Resource type
- Rights statement
- In Copyright
- Note
- Paper type: Research or research design
- Degree
- Master of Public Health
- Degree granting institution
- University of North Carolina at Chapel Hill
- Graduation year
- 2008
- Language
- Deposit record
- 564d1737-ca9b-4211-9c3e-c1926665c3df
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