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Abstract

This paper describes assessment practices related to discharging elderly patients from Australian acute public hospitals. Common assessments were of cognition, continence, wound care, hygiene needs, nutrition, mobility and self-care. Nurses and social workers commonly took non-standardised assessment approaches, whilst therapists were more likely to use published assessment instruments. Patients’ perspectives were rarely incorporated into assessments. The relationship between many common assessment items and patients’ ability to manage safely after discharge from hospital was unclear. The validity of assessment items, the reliability with which assessments were taken, ‘normal’ variability in responses, and interpretation of instrument ‘scores’ with respect to post-discharge independence were rarely considered.This study highlighted the need to consider organisational and professional barriers to good discharge planning practices, the purpose, frequency, validity and accuracy of discharge-related assessments, patients’ and carers concerns, health professionals’ capacity, opportunity and commitment to share assessment findings relative to planning discharge.

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