Nurse-led interventions to reduce avoidable emergency transfer and admissions to hospital from nursing homes: a scoping review

Abstract

Emergency transfers and hospitalizations of nursing home residents to acute care hospitals should be avoided if possible. Our study aimed to provide a broad overview of research on nurse-led interventions to reduce avoidable transfers and hospital admissions from nursing homes to acute care hospitals and to examine future research questions. Methods: We conducted a scoping review using three electronic databases （MEDLINE, CINAHL, Cochrane Library）. Results: Thirty-nine papers met the inclusion criteria and were categorized as follows: （1） interventions related to improving the quality of primary care, （2） interventions related to improving the quality of end-of-life （EOL） care, and （3） complex interventions that included elements of both primary and EOL care. Hospitalization were reduced by implementing care pathways, as well as interventions related to EOL decision support and those for care staff and by advanced practice nurses. The present study also suggests that complex interventions that combine multiple interventions might be useful. Conclusions: Given that many studies indicated that effectiveness includes multiple intervention elements, reducing avoidable transfers and hospital admissions from nursing homes would be better served by complex interventions.