Stroke patients entering nursing home care: a content analysis of discharge letters.
OBJECTIVE
To examine the information contained in medical and nursing staff hospital discharge letters for stroke patients entering nursing home care.


METHODS
A retrospective content analysis comparing case notes with discharge letters.


METHODS
Nottingham (UK) hospitals.


METHODS
Thirty-eight stroke patients with a Barthel Activities of Daily Living Index score of less than 11/20 at three months post stroke who were discharged into a nursing home.


METHODS
Patients' medical case notes and medical and nursing discharge letters were subjected to the same structured content analysis. The three key areas were: self-care ability (i.e. washing, dressing), nursing needs (i.e. diet, continence) and risk assessment (i.e. falls, pressure sores).


RESULTS
Discharge letters were least likely to provide information on risk assessments, for example only 14 (37%) documented the risk of pressure sores and 7 (18%) falls. Thirty discharge letters (79%) had information relating to self-care ability and nursing care, although a blanket term 'needs all care' was used to describe patient ability in 20 (66%) of these.


CONCLUSIONS
The results demonstrate that the completeness and accuracy of information is often poor, doing little to enhance the continuity of care for patients who are transferred from hospital to nursing homes.
Sackley
Catherine M
CM
Trent Institute for Health Services Research, Medical School, University of Nottingham, Queens Medical Centre, UK. cath.sackley@dphpc.ox.ac.uk
Pound
Kate
K
D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D015709:Correspondence as Topic; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000592:standards*; D010351:Patient Discharge / Q000592:standards*; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D000071939:Stroke Rehabilitation