Dados do Resumo

Título

NURSE’S ROLE IN DEHOSPITALIZATION: AN INTEGRATED APPROACH OF EXPERIENCE REPORT AND NARRATIVE REVIEW IN A CANCER CENTER

Introdução

Dehospitalization is the term used for the process of leaving hospital admission and transitioning care to less intensive and lower complexity environments. It requires planning and coordination to ensure safety and continuity of care. The practice involves comprehensive care and efficient management to promote recovery in comfortable settings and reduce costs. The specialist nurse is crucial for coordinating the transition and minimizing risks, ensuring a safe discharge.

Objetivo

This study aims to demonstrate the annual monitoring of dehospitalization cases, the contribution of the nursing professional, and its importance in the dehospitalization process. The goal is to minimize the risks of early readmission and enable patients to continue their treatment safely outside the hospital.

Métodos

This study employs an integrated approach combining an Experience Report and a Narrative Review: a holistic perspective on the dehospitalization process, care transition, and the importance of the specialist nurse’s role. The study was conducted at the Dehospitalization Unit of a tertiary-level, private oncology hospital located in São Paulo, with 377 beds. Data collection was based on records of dehospitalization processes conducted by the Unit from 2019 to 2023 (both before and after the pandemic). Data were collected and stored in an Excel® spreadsheet. The data were grouped by year (total requests) and according to the outcome type of the process.

Resultados

The results reveal significant changes in dehospitalization processes between 2019 and 2023, with a notable impact from pre- and post-pandemic conditions. We observed consequent changes during this period, showing differences in the total number of requests, the percentage of completed discharges, the annual percentage of denied dehospitalization requests, and the percentage of canceled requests due to clinical deterioration, clinical improvement, or death, which could occur before and after the operator's analysis. We were able to observe the importance of the dehospitalization nurse’s role as a facilitator of coordination and promotion of post-hospital care transition.

Conclusões

The study highlights the crucial role of the dehospitalization nurse in coordinating the transition of care post-hospital discharge. The nurse develops individualized care plans and collaborates with the multidisciplinary team and the health insurer to ensure continuity of treatment, aligned with the patient's needs and available resources. This coordination ensures a safe and effective transition, reducing the risk of readmissions and promoting continuous, personalized care.

Palavras Chave

Hospital discharge - Continuity of patient care - Oncology nursing