Answer 2 for NUR 590 When reviewing the literature for your evaluation plan and different types of evidence for your project, what gaps in the findings did you encounter?
There are several gaps identified while reviewing literature that could affect my project and future research. My project’s topic is about nurse telephone post hospital discharge follow-ups to reduce early unplanned readmissions among older adult patients. One of the gaps is inconsistent outcomes as some researchers established that phone follow-up is associated with reduced readmissions while others did not find significant impact of this intervention (Chang et al., 2023; Loon‐van Gaalen et al., 2021). This shows the need of standardized and more rigorous methodologies across studies on telephone follow-ups. Another issue is lack of standardized follow-up protocols in terms of calls content, timing, and frequency. For instance, there are studies that involved immediate follow-up calls post-discharge (hours to few days) and others that spaced calls for a relatively longer period (more than a week) (Chang et al., 2023; Loon‐van Gaalen et al., 2021). These differences in protocols makes it challenge to establish the most effective follow-up strategy. Moreover, there are several confounding factors that can influence early unplanned readmissions among older patients; these include age (some are much older), comorbidities, support systems, type of health condition, season (e.g., flu season), polypharmacy, and socioeconomic status (Glans et al., 2020). Therefore, future research must consider these factors for better understanding to whom are the telephone follow-ups most beneficial. In summary, future research should find standardized protocols, employ tailored approaches for different patient categories, and perform cos -effectiveness analysis of the intervention to provide rationale for allocating resources for the initiative.
References
Chang, P. C., Li, Y. C., Chen, H. J., Huang, H. C., Chen, W., Kuo, Y. C., & Fan, S. Y. (2023). Effectiveness of Using Telephone Follow-Up Intervention on the Unplanned Readmission of Older Adult Patients within 14 Days of Being Discharged from Hospital. International Journal of Gerontology, 17(4). Available at https://doi.org/10.6890/IJGE.202310_17(4).0003
Glans, M., Kragh Ekstam, A., Jakobsson, U., Bondesson, Å., & Midlöv, P. (2020). Risk factors for hospital readmission in older adults within 30 days of discharge – a comparative retrospective study. BMC Geriatrics, 20(1). Available at: https://doi.org/10.1186/s12877-020-01867-3
Loon‐van Gaalen, M., Linden, M. C., Gussekloo, J., & Mast, R. C. (2021). Telephone follow‐up to reduce unplanned hospital returns for older emergency department patients: A randomized trial. Journal of the American Geriatrics Society, 69(11), 3157–3166. https://doi.org/10.1111/jgs.17336
