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The Problems That Can Result From Lack Of Communication
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Many patients leave a hospital and return to their homes but still need nursing care. They transfer from a situation where there are highly-skilled doctors and nurses and all of the necessary equipment should it be needed, to a home environment where there may be formal or informal care and support from a caregiver which is often supported by visits from home care nurses.
Both the patients and the caregivers providing care and support delivery in Bournemouth may be struggling to take in potentially confusing information from a variety of clinicians in the hospital and also the home care nurses. The clinicians themselves have, in most cases, little idea of the home environment and the abilities of the patient, let alone those of the caregiver. The result is that the patient and the caregivers are largely left to figure it out for themselves, which in many cases can be an almost impossible job.
Patient care and safety at home is just as important as in a hospital, and if conditions in the home are unsafe for any reason can result in re-admissions. Home care actually decreases NHS costs, reduces stays in hospital, and frequently improves health outcomes as patients feel happier in their own surroundings. However, there are still a lot of problems. Figures suggest that around 13% of patients returned to home care suffer from some sort of problem that could have been avoided. Mostly, these are concerned with medications, with up to a third of those suffering problems experiencing some sort of adverse drug event.
One of the problems seems to be ineffective communication from the hospital to the home carer, as the caregiver often seems to be somewhat confused regarding medication. There is no doubt that more attention should be paid to how adverse events could be avoided, and in order to prevent hospital re-admissions, improve patient outcomes, and save money, it has to be acknowledged that there is a problem and it needs to be addressed.
Home care nurses are often provided with far too little information from the hospital and primary care after the patient has been discharged. This means that these nurses have to rely on the patient and their caregivers for information that is, hopefully, accurate and relevant. However, this can go radically wrong since the patient may be confused and may not be able to provide accurate information as a result not just of poor memory, but of failing to understand instructions in the first place. Certainly, all patients are given instructions when they are discharged, but the paperwork could have been lost, be difficult to understand, or may focus only on the primary discharge reason without providing sufficient information about comorbidities.
This means that home care nurses often have to rely on the patient caregiver for vital information which may not be forthcoming at all, or if it is may well be inaccurate. When a nurse has to make a decision based on inaccurate or misleading information it can result in an adverse event which can then lead to hospital re-admissions which in theory could be preventable.
Hospitals which are discharging patients into homecare usually don't know the homecare environment, and neither do they know the general requirements of the patient, nurses, or caregivers. Neither do their GP's who have to continue to care for the patient after discharge. Homecare nurses may be aware of these things but are often not in communication with the GP and therefore may not be able to share information with the GP.
Healthcare systems, clinicians, and GPs need to engage more with homecare nurses in order to understand their information needs, the patient environment, and the patient him or herself. Most homecare nurses are only too keen to help their patients and assist in providing better overall results, but if they are unable to access all the information they need or are provided with inaccurate information by the patient or the caregiver, it can make their lives very difficult indeed.
Even so, better communication between clinicians, homecare nurses, and caregivers will still not totally reduce the possibility of errors creeping in and hospital re-admissions occurring, but it will go a long way towards helping to reduce them to a lower number than happens today.
You-Cas is a Bournemouth-based care and support agency that can provide care in the home for any people who require it, be they elderly or unable to provide entirely for themselves as a result of illness or accident.
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