Evidence map›Paper›PMID 38532452›Full record

ArticleBMC health services research2024

Areas of consensus on unwarranted and warranted transfers between nursing homes and emergency care facilities in Norway: a Delphi study.

Arne Bastian Wiik, Malcolm Bray Doupe, Marit Stordal Bakken, Bård Reiakvam Kittang, Frode Fadnes Jacobsen, Oddvar Førland

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Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Arne Bastian WiikCentre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway. arbaw@hvl.no.
Malcolm Bray DoupeCentre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway.
Marit Stordal BakkenNational Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway.
Bård Reiakvam KittangUniversity of Bergen, Bergen, Norway.
Frode Fadnes JacobsenCentre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway.
Oddvar FørlandCentre for Care Research, West. Western, Norway University of Applied Sciences, Bergen, Norway.

Funding

Ministry of Education and Research 917641404Research council of Norway 320648
6 · The paper itself

Abstract

backgroundTransferring residents from nursing homes (NHs) to emergency care facilities (ECFs) is often questioned as many are terminally ill and have access to onsite care. While some NH to ECF transfers have merit, avoiding other transfers may benefit residents and reduce healthcare system costs and provider burden. Despite many years of research in this area, differentiating warranted (i.e., appropriate) from unwarranted NH to ECF transfers remains challenging. In this article, we report consensus on warranted and unwarranted NH to ECF transfers scenarios.

methodsA Delphi study was used to identify consensus regarding warranted and unwarranted NH to ECF transfers. Delphi participants included nurses (RNs) and medical doctors (MDs) from NHs, out-of-hours primary care clinics (OOHs), and hospital-based emergency departments. A list of 12 scenarios and 11 medical conditions was generated from the existing literature on causes and medical conditions leading to transfers, and pilot tested and refined prior to conducting the study. Three Delphi rounds were conducted, and data were analyzed using descriptive and comparative statistics.

resultsSeventy-nine experts consented to participate, of whom 56 (71%) completed all three Delphi rounds. Participants reached high or very high consensus on when to not transfer residents, except for scenarios regarding delirium, where only moderate consensus was attained. Conversely, except when pain relieving surgery was required, participants reached low agreement on scenarios depicting warranted NH to ECF transfers. Consensus opinions differ significantly between health professionals, participant gender, and rurality, for seven of the 23 transfer scenarios and medical conditions.

conclusionsTransfers from nursing homes to emergency care facilities can be defined as warranted, discretionary, and unwarranted. These categories are based on the areas of consensus found in this Delphi study and are intended to operationalize the terms warranted and unwarranted transfers between nursing homes and emergency care facilities.

Indexed as

Emergency Service, HospitalPatient TransferConsensusDelphi TechniqueHumansNorwayNursing HomesDelphi studyEmergency careNursing homePatient Transfer

Identifiers

PMID38532452
PMCPMC10964583

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.