Newswise — Chicago IL (November 21, 2013): Association of Rehabilitation Nurses (ARN) states successful post-acute care (PAC) transitions for individuals with disabling conditions must be facilitated by nurses with rehabilitation nursing training, knowledge, and experience in the Essential Role of the Rehabilitation Nurse in Facilitating Care Transitions white paper released at the Nursing Organizations Alliance meeting of the American Nurses Association (ANA) today. The integral role rehabilitation nurses have in providing vital guidance to post-acute patients with disabilities helps ensure the right care is provided at the right time and by the right providers. In fact, utilization of rehabilitation nurses, specifically Certified Rehabilitation Registered Nurses (CRRN), has been shown to decrease the length of stay in rehabilitation facilities. It is also essential that persons involved with healthcare policy decision making, educators, payors, and other stakeholders in healthcare, understand the value of the rehabilitation nurse’s essential role in facilitating care transitions.
According to studies, PAC is a significant part of the overall care of many Medicare patients and up to 35% of Medicare patients are discharged each year to a PAC setting (Gage, 2009). Of those Medicare patients discharged, almost one-fourth of Medicare beneficiaries discharged from the hospital to a skilled nursing facility were readmitted to the hospital within thirty days (Mor, Intrator, Feng, & Grabowski, 2010). Failure to determine the appropriate site of care has contributed to a high level of hospital readmissions. According to findings cited in the paper, current post-acute care transitions are fragmented, disorganized, guided by factors unrelated to quality of care or patient outcomes and does not promote utilization of clinicians skilled in advocating on behalf of the best interests of patients and their families.
Rehabilitation nurses possess skills needed to make appropriate care transitions including experience in advocating on behalf of the patient, understanding the scientific basis for healthcare decisions, and balancing various ethical needs of the patient. The white paper demonstrates rehabilitation nurses are defined by a unique skill set, which entails the knowledge and understanding of care management needed for populations with acute or chronic illnesses and conditions that cause disability. They are experts at leading teams to focus on helping patients in these vulnerable populations recover as much function as possible or manage new disability (e.g., incontinence) through the formulation and implementation of patient/family-centered interventions and evaluating outcomes. Rehabilitation nurses possess a comprehensive understanding of the resources available at each level of PAC.
Other recommendations include: (A) Rehabilitation nurses must be involved in national policy decisions including membership on committees and technical expert panels. (B) Studies are needed to evaluate impact of rehabilitation nurses on the healthcare delivery system. (C) Federal agencies must fund research supporting comparisons of payments and quality models as well as evaluation of value-based payment models. (D) Rehabilitation nurses should be included on Technical Expert Panels assessing concepts for future care coordination measure development, including transitional care, as a tool to evaluate the quality of care coordination for individuals with disabilities.
Association of Rehabilitation Nurses (ARN)ARN is a professional healthcare association dedicated to promoting and advancing professional rehabilitation nursing practice through education, advocacy, collaboration, and research to enhance the quality of life for those affected by disability and chronic illness. For more information about ARN, please visit www.rehabnurse.org or call 800.229.7530.###
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