Implementation and Evaluation of Discharge Planning for Patients Undergoing Umbilical Cord Blood Transplantation

Area of Science:

• Hematology
• Transplantation Medicine
• Patient Care Management

Background:

• Umbilical cord blood transplantation (UCBT) patients face significant challenges, including high rates of unplanned hospital readmissions and diminished quality of life (QoL).
• Effective post-discharge care strategies are crucial for improving outcomes in this vulnerable patient population.

Purpose of the Study:

• To evaluate the impact of a structured discharge planning program on unplanned readmissions, self-efficacy, QoL, and clinical outcomes in UCBT recipients.
• To assess the feasibility and effectiveness of implementing discharge planning from admission through 100 days post-transplant.

Main Methods:

• A prospective study involving 72 UCBT patients, randomized into a control group (usual care) and an intervention group (discharge planning).
• Readmission rates were tracked at 30 days post-discharge and 100 days post-UCBT.
• Self-efficacy and QoL were measured using validated scales (General Self-Efficacy Scale, FACT-BMT) at baseline and 100 days post-UCBT.

Main Results:

• Discharge planning did not significantly reduce 30-day or 100-day readmission rates compared to usual care (P > 0.05).
• The intervention group demonstrated significantly improved self-efficacy (P < 0.001).
• Quality of life scores, measured by the FACT-BMT, were significantly higher in the intervention group across most dimensions and total scores at 100 days (P < 0.05).

Conclusions:

• Structured discharge planning can enhance self-efficacy and improve the quality of life for patients undergoing UCBT.
• While not impacting readmission rates in this study, discharge planning is essential for facilitating a successful transition from hospital to home for UCBT recipients.