Sjuksköterskans erfarenheter av att förbereda patienter inför utskrivning – en intervjustudie från den psykiatriska heldygnsvården

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Sammanfattning: Background: Being discharged from psychiatric inpatient care is a critical phase for the patient. A well-prepared discharge reduces the risk of readmission and increases the probability of the patient complying to planned aftercare. The nurse has a responsibility to promote patient participation. Few studies describe the nurse’s experience of preparing the patient for discharge from psychiatric inpatient care. Aim: To describe the nurse’s experience of preparing the patient for discharge to home environment from psychiatric inpatient care. Method: A qualitative method was chosen. Collection of data was made through seven semi-structured interviews with nurses from psychiatric inpatient wards. Data were analysed using a qualitative content analysis. Results: The analysis resulted in three categories: Feeling safe before discharge, Preparing for aftertime and A dynamic process. Feeling safe before discharge describes how the nurses work to make the patient feel safe before discharge, and obstacles that may occur. Preparing for aftertime describes how the nurses create a plan for the time after discharge by coordinating with other instances, and plan for activity and ensuring of resources with the patient. A dynamic process describes the nurse’s work with the discharge process as sensitive to stress, characterized by cooperation with other professions, and is something in which the nurse evolves in working with. Conclusion: The nurses possess a lot of skills and work methods to prepare the patient for discharge. However, it is described to be a sensitive process lacking a structured way of work, and factors threatening the patient’s participation have been shown. There is a need of a common structure between the professions regarding the work around the discharge process. The care plan is a good tool when the discharge is planned, and protects the patient’s role as an active decision maker.

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