title: Development, validation and testing of a nursing home to emergency room transfer checklist.
abstract: OBJECTIVE
  To develop and test the feasibility of an instrument to support patients' nursing home to emergency room transfer.
  
  
  BACKGROUND
  Transfers from a nursing home care facility to an acute care facility such as a hospital emergency room are common. However, the prevalence of an information gap for transferring residents' health data to acute care facility is high. An evidence-based transfer instrument, which could fill this gap, is lacking.
  
  
  METHODS
  Development of a nursing home to emergency room transfer checklist, validation of items using the Delphi method and testing the feasibility and benefits of using the nursing home to emergency room transfer checklist.
  
  
  METHODS
  Items were developed based on qualitative data from previous research. Delphi validation, retrospective chart review (baseline data) and a 6-month prospective study design were applied to test the feasibility of using the checklist. Variables for testing the feasibility of the checklist included residents' 30-day readmission rate and length of hospital stay.
  
  
  RESULTS
  Development of the nursing home to emergency room transfer checklist resulted in four main parts: (i) demographic data of the nursing home resident; (ii) critical data for nursing home to emergency room transfer; (iii) contact information and (iv) critical data for emergency room to nursing home transfer. Two rounds of Delphi validation resulted in a mean score (standard deviation) ranging from 4.39 (1.13)-4.98 (.15). Time required to complete the checklist was 3-5 min. Use of the nursing home to emergency room transfer checklist resulted in a 30-day readmission rate of 13.4%, which was lower than the baseline rate of 15.9%.
  
  
  CONCLUSIONS
  The nursing home to emergency room transfer checklist was developed for transferring nursing home residents to an emergency room. The instrument was found to be an effective tool for this process.
  
  
  CONCLUSIONS
  Use of the nursing home to emergency room transfer checklist for nursing home transfers could fill the information gap that exists when transferring older adults between facilities such as nursing homes and hospitals.
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.|Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan.
authors.forename: Hsiu-Hsin
authors.initials: HH
authors.lastname: Tsai
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.|Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.|Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
authors.forename: Yun-Fang
authors.identifier: http://orcid.org/0000-0002-2148-314X
authors.initials: YF
authors.lastname: Tsai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist / Q000592:standards*; D003697:Delphi Technique; D004636:Emergency Service, Hospital; D005240:Feasibility Studies; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D007902:Length of Stay; D008297:Male; D009735:Nursing Homes; D010359:Patient Readmission / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000379:methods*; D011446:Prospective Studies; D036301:Qualitative Research; D012189:Retrospective Studies
keywords: emergency room; nursing home; transfer