The paradox of preventing hospital readmissions from community rehabilitation facilities – A constructivist study of nursing staffs’ experiences and perspectives

Abstract

Objective: Older people occasionally require a temporary stay in a community rehabilitation facility for care and monitoring after hospitalisation due to a deteriorating health status. The risk of readmission from community rehabilitation facilities is high because of the older patients complex medical situations but little is known of the nursing staffs’ actions directed towards preventing hospital readmissions from the facilities. This study aim to explore and describe the experiences and perspectives of the community rehabilitation facility nursing staff’s possibilities and interventions to prevent hospital readmissions of older patients.
Methods: This explorative qualitative study was underlined by a constructivist paradigm. Twenty-six nurses and nurse assistants from five community rehabilitation facilities comprised the nursing staff who participated in this study. They contributed to the data production by participating in five focus group discussions performed in May 2024 and analysed using Braun & Clarke’s thematic analysis.
Results: The overarching theme of “Their best is our worst” was found during the analysis which described the community rehabilitation facility nursing staff’s experiences and perspectives of why patients were at risk for hospital readmissions. This was supported by three themes: “Risking readmissions after hospital discharge,” “Lacking utilities and knowledge in the CRF,” and “Preventing readmissions through nursing interventions.”
Conclusions: Hospitals discharge older patients with complex healthcare needs to community rehabilitation facilities for special care and all-hour nursing attention before they return home. However, the facilities often lack the utilities and competencies to fully care for the patients and prevent them from being readmitted to the hospital.