Review: patients in nursing-led units are better prepared for discharge than those receiving usual care

摘要

QUESTIONAre nursing-led inpatient units (NLUs) more effective than usual inpatient care in preparing patients for discharge?METHODSData sources: Medline, CINAHL, EMBASE/Excerpta Medica, Cochrane Library, Healthcare Management Information Consortium database, and British Nursing Index (to November 2006); Cochrane Effective Practice and Organisation of Care Group's specialised register (to October 2006); ISI Web of Knowledge (to January 2007); and experts. Study selection and assessment: controlled trials that compared nurse-managed care in an NLU with usual inpatient care on a general acute hospital ward (managed by physicians) in adult patients after acute admission for any physical health condition. NLU care must have been a substitute for some or all of the acute hospital stay, rather than an addition to it. 8 randomised controlled trials (n=1147), 2 quasi-randomised trials (n = 749), and 1 controlled before-after study met the selection criteria (range of mean ages 64-81 y, 40-86% women). Quality of individual studies was assessed using the criteria of the Cochrane Effective Practice and Organisation of Care Group. Outcomes: included mortality, discharge to institutional care, functional status at discharge, length of hospital stay, readmission within 30 days, and costs.