title: Discharge Teaching, Readiness for Discharge, and Post-discharge Outcomes in Parents of Hospitalized Children.
abstract: OBJECTIVE
  This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).
  
  
  METHODS
  In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3weeks post-discharge (Post-Discharge Coping Difficulty Scale), and from electronic records (readmission, ED visits).
  
  
  RESULTS
  Parent-reported quality of discharge teaching delivery (the way nurses teach), but not the amount of content, was positively associated with parent perception (B=0.54) and nurse assessment (B=0.16) of discharge readiness. Parent-reported discharge readiness was negatively associated with post-discharge coping difficulty (B=-0.52). Nurse assessment of discharge readiness was negatively associated with readmission; a one point increase in readiness (on a 10 point scale) decreased the likelihood of readmission by 52%.
  
  
  CONCLUSIONS
  There is a sequential effect of quality of discharge teaching delivery on parent discharge readiness, which is associated with parent coping difficulty and child readmission.
  
  
  CONCLUSIONS
  Efforts to improve discharge outcomes should include strategies to build nurse teaching skills for high-quality delivery of discharge teaching. In addition, routine nurse assessment of discharge readiness can be used to identify children at risk for readmission and trigger anticipatory interventions.
authors.affiliation: College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, United States. Electronic address: Marianne.weiss@marquette.edu.
authors.forename: Marianne E
authors.initials: ME
authors.lastname: Weiss
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States; Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: ksawin@chw.org.
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Sawin
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States; Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: kgralton@chw.org.
authors.forename: Karen
authors.initials: K
authors.lastname: Gralton
authors.affiliation: College of Nursing, Marquette University, PO Box 1881, Milwaukee, WI 53201-1881, United States. Electronic address: Norah.Johnson@marquette.edu.
authors.forename: Norah
authors.initials: N
authors.lastname: Johnson
authors.affiliation: Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: klingbei@uwm.edu.
authors.forename: Carol
authors.initials: C
authors.lastname: Klingbeil
authors.affiliation: Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States; Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, United States. Electronic address: slerret@chw.org.
authors.forename: Stacee
authors.initials: S
authors.lastname: Lerret
authors.affiliation: Children's Hospital of Wisconsin, PO Box 1997, Milwaukee, WI 53201-0199, United States. Electronic address: mmalin@ilstu.edu.
authors.forename: Shelly
authors.initials: S
authors.lastname: Malin
authors.affiliation: School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, United States. Electronic address: yakushev@med.umich.edu.
authors.forename: Olga
authors.initials: O
authors.lastname: Yakusheva
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201-0413, United States. Electronic address: schiffma@uwm.edu.
authors.forename: Rachel
authors.initials: R
authors.lastname: Schiffman
mesh_terms: D000223:Adaptation, Psychological; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024802:Nurse's Role; D010290:Parents / Q000193:education*; D010351:Patient Discharge; D010359:Patient Readmission; D010371:Pediatric Nursing / Q000379:methods*; D010865:Pilot Projects; D011786:Quality Control; D018570:Risk Assessment; D014481:United States
keywords: Discharge readiness; Discharge teaching; Parent; Pediatric; Post-discharge; Readmission