Blood transfusion prescribing in the ACT: an insight into clinical decision making

Abstract

This study aimed to determine the perspectives of a group of patients categorised as ?long-stay outliers? at a large South Australian metropolitan hospital about aspects of organisation of care and the perceived impact of long-term hospitalisation. Nineteen patients were interviewed using a semi-structured questionnaire. Eighty-nine percent of participants stated that they had no knowledge of how long they were to be in hospital. Forty-two percent indicated that they did not know when they would be discharged from hospital. This was of concern, especially considering the vulnerability of this patient group and the known benefits of patient involvement in decision making and the improvements this can make to health outcomes and early discharge. Participants indicated concern about sleep deprivation, diet, ability to return to paid employment, and missing their family as the main areas of impact of their long hospitalisation. Concerns about being discharged from hospital included: apprehension as to whether they were well enough to leave; the recurrence of infection; whether they would be able to sleep well when they got home; their recent loss of appetite and associated weight loss; mobility concerns; and what supports they would have when they were discharged home. All these issues require staff to be more patient and family-centred in their approach to preparing for discharge.