Led by Regenstrief Institute Research Scientist Kristin Levoy, PhD, MSN, R.N., a meta-analysis of findings from 54 research (involving greater than 31,000 people) confirms that caregiver engagement throughout healthcare transitions (for instance from hospital to dwelling) of chronically sick adults is instrumental in stopping rehospitalizations, and holds potential for enhancing different affected person outcomes.
The work provides compelling empirical proof of the worth of caregivers in facilitating care transitions when the healthcare workforce actively companions with them to assist the affected person’s healthcare following discharge. This not solely included partaking caregivers in wants assessments and training (e.g., illness and medicine administration, pink flag recognition) previous to discharge, but additionally telemedicine follow-up post-discharge to assist caregivers in care coordination with different healthcare suppliers or supportive companies.
“In my own clinical practice, I have had multiple experiences of caregivers coming to me after a healthcare crisis of their loved ones to reflect on how they didn’t feel adequately prepared to support their loved ones’ care,” mentioned Dr. Levoy, who can also be an assistant professor at Indiana University School of Nursing. “These caregivers felt blindsided by how a lot care that they had to offer and ill-equipped for the weighty healthcare selections they have been concerned in.
“Caregivers play a critical role in enhancing patient outcomes and we can do a better job of supporting these unrecognized members of the healthcare team,” she added. “Caregivers often feel abandoned, particularly in times of healthcare crises, like an unexpected hospitalization, and we need to set them up for success, which includes addressing their unique needs. And these needs only grow greater as the chronic illness advances and the patient’s disease and treatment complexity increases.”
As adults age with power sickness, detrimental adjustments in well being standing could end in frequent and sometimes sudden transitions throughout healthcare settings, comparable to from dwelling to hospital and again to dwelling or to a talented nursing facility. On common, older adults will expertise between two and 5 healthcare transitions within the yr following a hospitalization.
Dr. Levoy requires additional research of healthcare supply fashions that make caregivers precise companions within the healthcare course of by supporting the care they supply to maintain a chronically sick cherished one from boomeranging again to the hospital.
“Caregiver Engagement Enhances Outcomes Among Randomized Control Trials of Transitional Care Interventions — A Systematic Review and Meta-analysis” is printed in Medical Care, a peer reviewed journal of the American Public Health Association. Authors, along with Dr. Levoy, are Eleanor Rivera, PhD, R.N., University of Illinois Chicago College of Nursing; Alexandra Hanlon, PhD, Virginia Tech College of Science; and Molly McHugh, BSN, R.N.; Karen B. Hirschman, PhD, MSW; and Mary D. Naylor, PhD, R.N., all of University of Pennsylvania School of Nursing.
The authors wrote, “Increasing support for caregiver engagement during care transitions may require the development of value-based reimbursement models that reward health care systems for the adoption of caregiver-engaged principles, creating an environment for systemic change in the way health care systems conduct business, which may also increase the capability of caregivers to provide care in the home over time, thus, delaying institutionalization.”
They conclude, “Whether in research or clinical practice, transitional care should not be conducted without careful consideration of where and how caregivers will be incorporated and supported as active partners in optimizing patient care across health care transitions.”
The research was supported by the National Institutes of Health’s National Institute of Nursing Research award T32NR009356.
Levoy, Okay., et al. (2022) Caregiver Engagement Enhances Outcomes Among Randomized Control Trials of Transitional Care Interventions: A Systematic Review and Meta-analysis. Medical Care. doi.org/10.1097/MLR.0000000000001728.
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