title: [Discharge from hospital into nursing home: conditions and quality of transmissions].
abstract: BACKGROUND
  Nursing home residents are very old, with multiple comorbidities and disabled for activities of daily living (ADLs). Therefore, they have a higher risk of accidents as falls or fractures or acute diseases as infections, which require hospitalization. Care's coordination and sharing of informations between hospitals and nursing homes are often insufficient even with agreements. Thus, discharge to nursing homes after hospitalization may be difficult for old patients because of incomplete oral or written transmissions.
  
  
  OBJECTIVE
  To examine both protocols and the quality of the return to the nursing homes after an hospitalization for old residents.
  
  
  METHODS
  A prospective multicenter study done by collecting data about consecutive returns into their nursing home after an hospitalization of more than 24 hours of nursing home residents aged 65 years and more.
  
  
  RESULTS
  Twenty-eight nursing homes of the North of France were enrolled in the study. During the 3 months period of the study, 246 discharges after an hospitalization of 24 hours or more were registered. 225 residents (165 women and 60 men), mean age 85.0 ± 7.2, were concerned. Most of them were ADLs disabled, with a dementia for 47.1% of them. The average length of hospitalization was 11.6 days. At the end of hospitalization, the notification of return, which was made only in 82% of cases, was announced in average 1.3 days before the discharge. Unfortunately, in 32% of cases, the notification was made the day of the discharge. Residents went back home indifferently any day of the week but more often the Friday and less often the weekend. The day and the hour of the planned discharge were respected in 79.1% of cases. In most cases, nursing home caregivers have considered that the clinical status was stable or improved compared to the previous one. However in 28% of cases, a loss of autonomy was found. Medical doctors wrote a letter of discharge in 85.8% of cases. Nurses gave written transmissions only in 41.9% of cases.
  
  
  CONCLUSIONS
  Many points concerning discharge from hospital, about old people living in nursing home, have to be improved: oral transmissions about patient's status, notification of the return, discharge's letter, nurse's transmissions and assessment of the loss of autonomy.
authors.affiliation: Clinique de gérontologie, hôpital gériatrique Les Bateliers, CHRU de Lille, 59037 Lille, France. Electronic address: isabelle.delabriere@chru-lille.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Delabrière
authors.affiliation: Clinique de gérontologie, hôpital gériatrique Les Bateliers, CHRU de Lille, 59037 Lille, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Delzenne
authors.affiliation: Clinique de gérontologie, hôpital gériatrique Les Bateliers, CHRU de Lille, 59037 Lille, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Gaxatte
authors.affiliation: Clinique de gérontologie, hôpital gériatrique Les Bateliers, CHRU de Lille, 59037 Lille, France; Université de Lille-2, faculté de médecine Henri-Warembourg, 59045 Lille, France.
authors.forename: François
authors.initials: F
authors.lastname: Puisieux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011446:Prospective Studies