UBC Graduate Research

Safe transitions from hospital to home for elderly cardiac patients : an integrative review Phillips, Jennifer


Background: Elderly patients who are discharged after invasive cardiac surgery or transcatheter aortic valve replacement/implantation (TAVR/TAVI) are at risk of experiencing problems and complications with their healthcare needs when they transition from hospital to home. Elderly patients may feel unprepared, overwhelmed, and unsupported with how to manage their care needs. Thus, it is essential for healthcare providers to be aware of the challenges this age group face and engage in best practices and approaches to help facilitate a safe transition for this vulnerable patient population. Objective: To explore the current research literature in order to identify evidence-informed approaches and best practices to help support and facilitate safe transitions from hospital to home for elderly patients after elective, invasive cardiac surgery or TAVR/TAVI. Methods: For this integrative review, three databases, Medline (Ovid), CINAHL, and Web of Science, were searched for literature. Inclusion criteria of literature were: (1) reported on research studies using quantitative, qualitative, or mixed methods; (2) focused on the elderly; (3) were written in English; (4) were published between January 2014 and December 2018; and (5) addressed one of the three research questions of this integrative review. Results: 15 articles met inclusion criteria. Five addressed patient experiences of their transitions, two addressed predictors or risk factors associated with poor transitions, and nine addressed interventions that have been designed to reduce poor transitions and/or readmissions to hospital. Thirteen studies provided information on how to support and facilitate a safe transition from hospital to home for elderly patients. Conclusion: There is limited research on this topic and more specifically on this population of patients. Healthcare professionals need to be more aware of the challenges elderly patients face in their transitions and they require on-going and additional education in how to support them. Additionally, in order to improve transitions further, organizations may need to be restructured and policies may need to be developed or changed. Elderly patient transitions are an important issue in healthcare and additional research is necessary in improving care for this vulnerable patient population. Keywords: Elderly patients, transitions, safe transitions, cardiac surgery, coronary artery bypass graft, transcatheter aortic valve replacement, transcatheter aortic valve implantation.  

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