Evidence map›Paper›PMID 41035658›Full record

ReviewInternational journal of nursing studies advances2025

Improving delayed discharge in gastrointestinal surgery patients: An integrative review.

Mathulada Chaimee, Jutharat Attawet, Yunjing Qiu, Thomas J Hugh, Pauline Murray-Parahi, Amanda Wilson

Abstract readReview
In one paragraph

Review in International journal of nursing studies advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. 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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mathulada ChaimeeSchool of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Jutharat AttawetSchool of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Yunjing QiuSchool of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Thomas J HughSurgery Sydney Medical School - Northern, The Sydney University, Sydney, Australia.
Pauline Murray-ParahiSchool of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Amanda WilsonSchool of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Delayed discharge is a global challenge that strains healthcare systems and affects patient outcomes. In gastrointestinal surgery patients, delays often result from a continuum, clinical complications prolong the acute stay and create additional care needs, such as rehabilitation and specialised homecare, which lead to further delays. However, existing literature provides limited insight into this patient group, as most studies generalise the issue. A focused integrative review is therefore needed to synthesise the causes, impacts, and strategies of delayed discharge and to inform more effective discharge planning. Objective: This review aims to synthesise evidence related to delayed discharge in patients undergoing gastrointestinal surgery. Specifically, it seeks to: (1) identify multi-level contributing factors (patient, clinical, and healthcare system); (2) evaluate significant clinical and economic impacts on patients, family, healthcare staff and healthcare system; and (3) identify and describe effective interventions implemented to promote timely and safe discharge in this population. Method: A literature search was conducted across CINAHL, Medline, Scopus, Cochrane, and PsycINFO databases for studies published from 2000 to January 2025. Keywords used included "delayed discharge," "factors," "impact," "gastrointestinal surgery," and "intervention." Inclusion criteria focused on peer-reviewed studies involving adult gastrointestinal surgery patients in acute hospital settings. Two authors independently screened titles, abstracts, and full texts using the Joanna Briggs Institute SUMARI software. The methodological quality of studies was assessed using the Joanna Briggs Institute critical appraisal tools. Data extraction focused on study characteristics, factors, impacts, and interventions, followed by a deductive narrative analysis to identify patterns and relationships. Results: Of the 572 articles identified, 20 met inclusion criteria: 17 cohort studies (12 retrospective, five prospective), one analytic cross-sectional study, and two clinical trials. The findings encompassed the length of stay and delayed discharge rate, contributing factors, impacts, and potential interventions. Delayed discharge stemmed from patient, surgical, and system-related factors, affecting patients and hospital efficiency. Targeted interventions, like nurse-led stoma education and streamlined discharge criteria, significantly reduced delays ( Conclusion: Delayed discharge in gastrointestinal surgery patients stems from a complex interplay of patient, surgical, and systemic factors, affecting both individual and healthcare system. Evidence supports nurse-led and multidisciplinary approaches in mitigating delays, improving outcomes and enhancing healthcare efficiency. Future research should employ qualitative or mixed-methods approaches to explore the psychosocial impacts on patients, families, and healthcare staff, in collaboration with comprehensive, multidisciplinary discharge strategies.

Indexed as

Care transitionsColorectal surgeryDelayed dischargeDischarge planningGastrointestinal surgical proceduresLength of stayMultidisciplinary care teamPostoperative carePostoperative complicationsSurgical patients

Identifiers

PMID41035658
PMCPMC12482300

What OpenQuestion holds

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Registered trials

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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.