Reducing Avoidable Hospital Transfers From Nursing Homes in Austria: Project Outline and Baseline Results

Area of Science:

• Geriatrics
• Health Services Research
• Nursing

Background:

• Hospital transfers from nursing homes (NHs) are frequent, burdensome, and often avoidable.
• Existing interventions primarily focus on nurses' knowledge and skills, with limited evidence on effectiveness.
• A need exists for integrated interventions involving both nurses and physicians to reduce these transfers.

Purpose of the Study:

• To report preintervention data from a project implementing integrated nurse and physician interventions in 17 NHs.
• To assess hospital transfer rates and resident data before intervention implementation.
• To evaluate nurses' preintervention knowledge and self-efficacy.

Main Methods:

• Prospective collection of hospital transfer rates (N=1,520) and resident data (N=1,238).
• Assessment of nurses' knowledge and self-efficacy using standardized questionnaires (N=330).
• Analysis of transfer initiation, physician involvement, and polypharmacy during the preintervention period.

Main Results:

• High rates of hospital transfers were observed.
• Many transfers were initiated by nurses without physician involvement.
• Polypharmacy was common, indicating a significant potential for transfer reduction through increased physician presence.
• Nurses demonstrated low knowledge but high self-efficacy.

Conclusions:

• Integrated interventions involving nurses and physicians are crucial for reducing avoidable NH hospital transfers.
• Enhancing physician presence and implementing geriatric quality circles are key intervention components.
• Addressing nurses' knowledge gaps alongside physician involvement is essential for improving resident care and reducing transfer rates.