Planning for our patients during times of transitions (for example: hospital to home, home to rehabilitation facility) involves collaboration with a number of healthcare professionals. Please address the following questions:
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How does your facility promote interprofessional collaboration during times of patient transitions? (Look at this from a surgical nurse point of view…preop nurse, to intraop nurse, to PACU/Recovery nurse, to same-day surgery discharge to home or post operative care facility)
What is the role of the nurse in patient transitions?
What gaps can you identify in this process related to quality of care?
While the role of the nurse in patient transitions can be multifaceted, it is our role to ensure that all of the necessary steps are taken to ensure the safety and well-being of our patients during this time. For example:
In order to promote interprofessional collaboration during times of patient transitions, we must ensure that our surgical nurses are properly trained on how to collaborate with other healthcare professionals. We also work closely with oncology nurses to help them understand the needs of their patients undergoing cancer treatment and what they can expect after surgery.
We must also ensure that all nurses are aware of their roles as caregivers and providers during times of patient transitions. Nurses play an important role in providing care for patients before, during, and after surgery; this includes providing information about post-surgical recovery plans (such as pain management) and preparing them for discharge from the hospital or rehabilitation facility.
Nurses also play an important role in making sure that proper documentation is being captured so that both patients and families are able to understand what occurred during their stay at [hospital name]. Acceptable documentation includes discharge summaries for each day spent in the hospital (for those who require respiratory therapy) or rehabilitation facility (for those who require physical therapy).
There are many gaps in this process related to quality of care. For example, there may be delays in getting consent forms signed by family members or administration of medications due to confusion about who should sign them. In addition, communication between different groups may be lacking due to lack of familiarity among certain individuals within each group or due to language barriers between English speakers and Spanish speakers for example).
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