Discharge management to ensure continuity of care: experience of portuguese liaison nurses

Objective: To describe the activities performed to ensure continuity of care by liaison nurses in hospital services. Method: Descriptive exploratory study with 107 nurses conducted from September 2016 to March 2017, in 15 hospitals in Portugal. Data was collected with a semi-structured questionnaire and the absolute frequencies were calculated for data analysis. Results: Fifty-one 51 (47.7%) patients who require continuous care were identified by physicians and nursing assistants; 69 (64.5%) health professionals used specific criteria to identify the discharge risk factors. The elements considered in the discharge planning are motor and functional recovery; 54 (30.86%); and caregiver’s capacity to provide caregiving activities, 41 (23.43%). Most information related to care continuity is exchanged by email, 58 (25.55%). Conclusion: The activities associated with continuity of care are not homogeneous among the professionals who carry out liaison activities, but contribute to the use of more consistent strategies for coping with discontinuity of care.