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Identify and describe patient engagement interventions used to improve medication management in older adults during transitions of care.
A mixed-methods systematic review.
A comprehensive search of all study designs was conducted. Studies were categorised using the ladder of patient and family engagement, a framework that positions engagement from low (passive) to high (active partnership) patient engagement.
Six databases were searched from inception to April 2024.
The search yielded 29 reports, with 25 classified as studies. Most interventions (n = 19, 76%) were low-level interventions that comprised informing patients in a passive manner. Interventions that facilitated high-level engagement (n = 6, 24%) where patients were integrated in the decision-making process were associated with consistently improved patient and healthcare long-term outcomes.
While low and high-level engagement interventions were associated with significantly decreased hospital readmission rates, high-level interventions consistently demonstrated positive patient outcomes. Interventions supporting older adults beyond discharge achieved meaningful and lasting patient and healthcare outcomes for older adults.
Findings provide clinical reference for designing engagement interventions, highlighting long-term benefits of partnership-based approaches and continuity beyond discharge.
Engagement in medication management during transitions of care varied significantly. High-level engagement was consistently linked to improved patient and healthcare outcomes but was often resource intensive. This review identifies the need to design balanced interventions that align with the preferences of older adults and real-world contextual healthcare settings.
PRISMA guidelines.
No patient or public contribution.
PROSPERO (registration number CRD42024557385).
To analyse the experiences of emergency nurses caring for patients with mental health issues in the emergency department, identify the challenges they face during the care process, and explore potential solutions.
A qualitative study.
Twenty-one nurses from three emergency medical centres in South Korea were recruited using purposive and snowball sampling methods for this study. Data were collected through focus group interviews from March 18 to April 12, 2024, and analysed using thematic analysis.
Analysis of the nurses' experiences revealed three main themes: ‘Challenges in providing care for patients with mental illness’, ‘Emotional burden of caring for patients with mental illness’, and ‘Experiencing limitations in psychiatric nursing competency’. Nurses face structural, systemic, and institutional barriers that hinder the provision of quality care to patients with mental health problems and experience emotional distress during the nursing process.
Caring for patients with mental health problems in the emergency department negatively impacts the treatment and safety of patients with mental illness, other patients in the emergency department, and nurses' emotional well-being and job satisfaction. This highlights the need for multifaceted efforts to ensure safe and effective mental health nursing in emergency settings. With appropriate improvements, more specialised and safer mental health nursing services can be provided to patients visiting the emergency department for mental health issues.
Organisational and policy-level support is needed to provide safe and effective care to patients with mental health problems in the emergency department. This includes structural improvements, the establishment of standardised safety protocols, strengthened support for nurses' mental health, development and implementation of emergency department-specific training programs, and the expansion of specialised personnel.
The COREQ guidelines were used to report the qualitative studies.
No patient or public contribution.
FreshRSS 