title: Homecare Nurses' Decision-Making During Admission Care Planning.
abstract: The re-hospitalization rate of homecare patients within 60 days of hospital discharge is 30%. Enhanced care planning based on better information may reduce this rate. However, very little is known about the homecare admission and care planning processes. The research team collected data during observations of three nursing visits to admit homecare patients in Camden NJ, and conducted thematic content analysis on these data. Human factors methods helped to identify nurse decision-making related to selection of the plan of care problems, non-nursing resources, and the nursing visit pattern. They identified how the electronic health record (EHR) assisted the nurse in visit pattern frequency decisions. Major themes that emerged included reduced efficiency due to use of redundant intra-team communication methods to augment EHR documentation, redundant documentation, and workarounds and reorganization of clinical workflow.
authors.affiliation: Drexel University College of Nursing and Health Professions, Philadelphia, PA, USA.
authors.forename: Paulina
authors.initials: P
authors.lastname: Sockolow
authors.affiliation: Drexel University College of Nursing and Health Professions, Philadelphia, PA, USA.
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Bass
authors.affiliation: Drexel University School of Biomedical Engineering, Science and Health Systems, Philadelphia, PA, USA.
authors.forename: Carl L
authors.initials: CL
authors.lastname: Eberle
authors.affiliation: University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Bowles
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data*; D064691:Nurses, Community Health / Q000706:statistics & numerical data*; D010347:Patient Care Planning / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015143:Philadelphia; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data