Post-discharge Follow-up Care: Nurses' Experience of Fostering Continuity of Care: A Qualitative Study

The Open Nursing Journal 13 Feb 2024 RESEARCH ARTICLE DOI: 10.2174/0118744346284419240205145438



In contemporary healthcare, ensuring continuity of care beyond hospitalization is imperative for optimizing patient outcomes. Post-discharge Follow-up Care (PFC) has emerged as a crucial component in this endeavor, especially with the integration of virtual platforms.


This study aims to thoroughly investigate nurses' experiences in providing Post-discharge Follow-up Care (PFC) to improve its implementation.


A descriptive qualitative study was conducted to explore nurses’ experiences of conducting nurse-led follow-up care. This study was conducted at University Hospital, involving nine nurses with experience in administering PFC. Data were collected through focus group interviews. Thematic analysis was performed to identify recurring patterns and themes within the data.


The thematic analysis yielded four overarching themes: 1) “Caring nurse virtually,” emphasizing nurses' dedication to compassionate virtual care, 2) “Constraints and limitations of continuing care,” highlighting challenges in resource management and coordination, 3) “Continuous documentation and coordination,” underscoring their vital role in seamless patient care, and 4) “Nurses’ expectation of technology features,” showing nurses' hopes for advanced features to enhance PFC.


This study provides deep insights into the experiences of nurses in delivering PFC through virtual platforms. It underscores the significance of maintaining emotional connections with patients, even in a virtual environment. The challenges faced in resource management and coordination highlight areas for potential improvement. Additionally, the study highlights the crucial role of accurate documentation and inter-team coordination in ensuring the continuity and quality of care. The nurses' expectations for technological advancements emphasize the need for ongoing innovation in healthcare delivery. These findings collectively contribute to the ongoing evolution of virtual follow-up care practices, ultimately enhancing patient outcomes and experiences beyond the hospital setting.

Keywords: Continuity of care, Follow-up care, Nurses, Post-discharge, Qualitative study, Virtual care.
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