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. 2020 Mar;29(3):157-168.
doi: 10.1177/1054773819835015. Epub 2019 Apr 21.

"They Don't Trust Us": The Influence of Perceptions of Inadequate Nursing Home Care on Emergency Department Transfers and the Potential Role for Telehealth

Caroline E Stephens  1 , Elizabeth Halifax  2 , Daniel David  1 , Nhat Bui  3 , Sei J Lee  4   5 , Janet Shim  6 , Christine S Ritchie  4
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"They Don't Trust Us": The Influence of Perceptions of Inadequate Nursing Home Care on Emergency Department Transfers and the Potential Role for Telehealth

Caroline E Stephens et al. Clin Nurs Res. 2020 Mar.

Abstract

In this descriptive, qualitative study, we conducted eight focus groups with diverse informal and formal caregivers to explore their experiences/challenges with nursing home (NH) to emergency department (ED) transfers and whether telehealth might be able to mitigate some of those concerns. Interviews were transcribed and analyzed using a grounded theory approach. Transfers were commonly viewed as being influenced by a perceived lack of trust in NH care/capabilities and driven by four main factors: questioning the quality of NH nurses' assessments, perceptions that physicians were absent from the NH, misunderstandings of the capabilities of NHs and EDs, and perceptions that responses to medical needs were inadequate. Participants believed technology could provide "the power of the visual" permitting virtual assessment for the off-site physician, validation of nursing assessment, "real time" assurance to residents and families, better goals of care discussions with multiple parties in different locations, and family ability to say goodbye.

Keywords: care transitions; emergency department; focus group; nursing home; telehealth.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
“They don’t trust us” driving NH to emergency room transfers. Note. NH = nursing home; ED = emergency department.
See this image and copyright information in PMC

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