Design This study was an exploratory descriptive design that employed a survey approach for data collection. Methods Two precoded questionnaires were constructed, one for administration to emergency department staff and the other to primary care staff in a number of settings. The question- naires were based on, and adapted with permission, from the instruments developed by McKenna et al. (2000). Reliability and validity of the original questionnaire was confirmed in the context of the initial study. Both questionnaires consisted of a section designed to collate demographic details from respondents including gender and grade. A second section of each questionnaire was designed to be specific to either the emergency depart- ment or the primary care sector. A range of forced (yes/no), dichotomous, multiple and likert type closed questions were used to elicit responses to specific areas of the management and discharge of the older person from the emergency department to the primary care sector. Both questionnaires also incorporated a small number of open ended, unstruc- tured questions designed to elicit a qualitative response to perceived problems and to comment on possible solutions. To ensure content validity, the modified questionnaires were
assessed by an expert group with membership drawn from healthcare managers, a research supervisor and three senior academic colleagues in higher education and practice settings. Questionnaires were administered to the identified samples in the emergency department by hand delivery and to staff in the primary care sector by postal delivery. The quantitative data was analysed using SPSS (Version 11.0) (SPSS Inc., Chicago, IL, USA) while the qualitative data were analysed manually using Microsoft Word. Access and ethical considerations Access to records and staff members included in the study was approved by senior nursing management and adminis- trative officers in both the primary and secondary care areas. Ethical approval was granted by operational managers within the current policies of the local Ethics Committee. Informed consent was obtained from the healthcare professionals involved. Sample The sample (n = 222) included: all grades of qualified nurses (clinical nurse managers, staff nurses) (n = 27) and all grades of medical staff (consultants, registrars, senior house officers) (n = 34) in the emergency department; all PHNs (n = 59), all practice nurses (n = 34) and GPs (n = 68) in the primary care area. Presentation of results Results are recorded under a number of key headings relevant to liaison and documentation of information on discharge which reflect the themes that emerged from the content analysis of responses within the questionnaires.
Demographics Of the questionnaires distributed a total of 135 were returned (60Æ81%). Responses from the primary care sector included the following: PHNs: n = 55; GPs: n = 32 and practice nur- ses: n = 18. Respondents from the emergency department included 11 doctors from various grades (intern, senior house officer, registrar and consultant) and 19 nurses from various grades (staff nurse, clinical nurse manager 2 & 3).
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