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  Outstanding4 points Very Good3 points Good2 Points Unacceptable1 point
Integration of Knowledge 12.5% The paper demonstrates that the author fully understands and has applied concepts learned in the course. Concepts are integrated into the writer’s own insights. The writer provides concluding remarks that  show analysis and synthesis of ideas The paper demonstrates that the author, for the most part, understands and has applied concepts learned in the course. Some of the conclusions, however, are not supported in the body of the paper The paper demonstrates that the author, to a certain extent, understands and has applied concepts learned in the course The paper does not demonstrate that the author has fully understood and applied concepts learned in the course.
Topic Focus 12.5% The topic is focused narrowly enough for the scope of this assignment. A thesis statement provides direction for the paper, either by statement of a position or hypothesis The topic is focused but lacks direction. The paper is about a specific topic but the writer has not established a position. The topic is too broad for the scope of this assignment. The topic is not clearly defined
Depth of Discussion 12.5 % In-depth discussion and elaboration in all sections of the paper. In-depth discussion and elaboration in most sections of the paper. The writer has omitted pertinent content. Quotations from others outweigh the writer’s own ideas excessively. Cursory discussion in all the sections of the paper or brief discussion in only a few sections
Cohesiveness 12.5% Ties together information from all sources. Paper flows from one issue to the next without the need for headings. Author’s writing demonstrates an understanding of the relationship among material obtained from all sources For the most part, ties together information from all sources. Paper flows with only some disjointedness. Author’s writing demonstrates an understanding of the relationship among material obtained from all sources. Sometimes ties together information from all sources. Paper does not flow. Disjointedness is apparent.  Author’s writing does not demonstrate an understanding of the relationship among material obtained from all sources. Does not tie together information. Paper does not flow and appears to be created from disparate issues. Headings are necessary to link concepts. Writing does not demonstrate understanding any relationship
Spelling and Grammar 12.5% Minimal spelling and/or grammar mistakes Some spelling and or grammar mistakes. Noticeable spelling and grammar mistakes. Unacceptable number of spelling and/or grammar mistakes
Sources 12.5% More than 5 current sources, of which at least 3 are peer review journal articles or scholarly books. Sources include both general background sources and specialized sources. Special-interest sources and popular literature and acknowledged as such if they are cited. All web sites utilized are authoritative. 5 current sources, of which at least 2 are peer-review journal articles or scholarly books. All web sites utilized are authoritative. Fewer than 5 current sources or fewer than 2 of 5 are peer-reviewed journal articles or scholarly books. All web sites utilized are credible. Fewer than 5 current sources or fewer than 2 of 5 are peer-reviewed journal articles or scholarly books. Not all web sites utilized are credible, and/or sources are not current.
Citations 12.5% Cites all data obtained from other sources. APA citation style is used in both text and bibliography Cites most data obtained from other sources. APA citation style is used in both text and bibliography. Cites some data obtained from other sources. Citation style is either inconsistent or incorrect. Does not cite sources.
 
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Challenges in Transitional Care

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Challenges in Transitional Care

Institutional Affiliation

Student Name

Brief Literature Review

The provision of quality transitional care is significant to all patients since it helps to ascertain that the care needs of the patients are fulfilled once they transition across different care settings. According to McDonagh& Kelly (2010), challenges associated with transitional care result in adverse negative outcomes such as higher healthcare costs, unnecessary hospital readmission rates, reduced life quality and satisfaction levels of the patient as well as increased burden on the caregivers. Coleman and Berenson (2004) note that hospital readmission rates have increased by 37% especially among elderly patients with stroke conditions. Coleman and Berenson (2004) further add that the problem is projected to worsen with the expected population increase of older adults. A number of studies have established that adverse events take place within transitional care and that elderly patients with complex care needs tend to be at higher risks. Additionally, Allen et. al. (2014) maintains that at least 49% of patients experience at least one instance of distance-related medical errors or adverse events during the transitional care period. Some of these events have been reported to be preventable and that their severity could be reduced through the use of earlier corrective actions as they are often brought up by issues like diagnostic test follow-up errors, falls, infections and drug mix-ups(Toles et. al., 2016). The severity of these events may result in permanent disability or in some cases death. At least 50% of the patients experiencing such adverse conditions end up requiring extra health-care services hence increased hospital readmission rates. LaMantia et. al., (2010) notes that the existence of such transitional care problems are brought about by ineffective and poor communication and inconsistencies in the exchange of patient information among the health care providers. In overall, therefore, the literature proposes that there is need to conduct additional research on transitional care in a bid to increase understanding on how the quality of transitional care, especially for the elderly patients, can be enhanced.

Methodology and Design of the Study

The study on transition care covers the hospital admission of patients all the way to their being discharged to their homes under the care of their caregivers. Hence the methodology of the study will include the participant observation study on the admission and discharge transition process. Such will involve having holding conversations with some of the elderly patients as well as their caregivers in regards to their awareness on the providence of transitional care. The observation method will also include a close analysis of the handling of the patients throughout their admission process until they are discharged. Such will include observing how the nurses receive the patients, their conduct in emergency departments as well as how they take care of the patients when in their medical wards. Additionally, the observation method will also cover information on the mode of interactions, coordination, and dialogue between the patients and the health practitioners’ right from the day of admission all the way to the day the patients are discharged from hospitals.

Sampling Methodology

To recruit participants in the study, the sampling method was used. Also, different municipalities were consulted and different nursing leaders were selected using the sampling method, to take part in the interviews hence enhancing the research process. The interviews helped to shed light on the role played by the nursing leaders in the transitional care process for older patients. Hence the interviews were used to collect data and also to dictate the key areas that the nurse leaders should address, as a means to ascertain any existing challenges in transitional care. The interviews were structured in a manner that starts with the general information on transitional care, then on the transition process and lastly on the experiences of the patients during the transition care period. Such will help to collect key information on all aspects of transitional care starting from when the patients are admitted to hospitals all the way to when they are released home and during their recovery period at home.

Necessary Tools

The research process will involve the use of different tools and technologies. The primary consideration, however, is on whether the technology information tools used in the healthcare settings assist to ease the transitional care process. It is critical to note that there exist multiple technologies used in the provision of transitional care among them electronic health records of the patients. These records contain information on the patients and can easily be retrieved to enhance the treatment process.  Also, these records incorporate the clinical decision support which enables the nurses and other key health care personnel to make informed decisions regarding the well-being of the patients. In essence, therefore, health IT experts perform multiple roles with respect to fulfilling transitional care. It is critical to capture all information pertaining to patient needs as it helps to inform the transition care process in addition to the medical history of the patients as well as what needs to be done to help foster their quick recovery. As a result, it is important that the IT health systems are designed in a manner that helps to support the transition process, hence assisting patients to go through the transition process with more ease. Additionally, with the provision of information technology, healthcare professionals can best communicate with the caregivers taking care of the patients hence helping to improve to reduce the instance of hospital readmissions.

Any Algorithms/Flow Maps Created

The main algorithm flow created during the research process is the Fourier Transform. The Fourier transform is regarded as one of the key algorithm methods to be used in healthcare settings (Chen, 2016). Generally, the Fourier transform is a technique used to break down complex signals thus enabling healthcare providers to realize the variations in their activities and to determine the best outcome needs for the patients. Such helps to ensure that the healthcare personnel meet their objectives within the organization and also to confirm whether the patients are fit to be discharged home(Chen, 2016). The second algorithm that will be created is the Mumps algorithm. The Mumps algorithm was recently developed to meet the current patient needs in the medical sector (Baronov &Evan, 2018). Hence, the Mumps algorithm functions as an operating system which helps the health care experts to understand the different aspects of patient needs and to determine on the course of action to be taken (Baronov &Evan, 2018). The Mumps algorithm is currently used in the powering of the all the hospital department hence helping to manage patient clinical records and enabling the healthcare personnel to be fast in assessing the patient health care records thus improving the overall workplace efficiency (Baronov &Evan, 2018). The third algorithm method created is the use of probabilistic data which is a technique that enables for different computer searchers which are deterministic to be carried out. The algorithm technique is very important since it ranks different types of information depending on the likelihood of the patients to adapt well to these methods hence helping to estimate the time that it will take for the patients to remain in hospital (Leyenaar et. al., 2016). Hence the probabilistic data technique is important in the transitional care process as it helps to see that patients remain in hospital long enough until they are fit enough to be absorbed into the home care systems (Leyenaar et. al., 2016). Lastly, medical algorithms are important in aiding the decision-making process hence helping to promote safe healthcare as it eliminates any errors on the part of the healthcare personnel when provided health care services(Chen, 2016).  With the increased cases of medical errors, the medical algorithms come in handy in helping the health care personnel to provide quality health care services and to understand the patient needs hence effectively determining the patients who require specialized care during the transitional care process(Chen, 2016).  Therefore, a medical algorithm in this respect functions as a decision tree which helps to go about complex decisions with the help of programming. In this case, therefore, medical algorithms help to eliminate existing uncertainties in the decision-making process hence improving efficiency in the provision of transitional care

References

Allen, J., Hutchinson, A. M., Brown, R., & Livingston, P. M. (2014). Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review. BMC health services research, 14(1), 346.

Baronov, D. V. & Evan J. B. (2018).Systems and methods for transitioning patient care from signal based monitoring to risk-based monitoring. U.S. Patent Application 10/062,456, filed August 28, 2018.

Chen, E. T. (2016).Examining the influence of information technology on modern health care.Effective Methods for Modern Healthcare Service Quality and Evaluation (pp. 110-136).IGI Global.

Coleman, E. A., & Berenson, R. A. (2004).Lost in transition: challenges and opportunities for improving the quality of transitional care. Annals of internal medicine, 141(7), 533-536.

LaMantia, M. A., Scheunemann, L. P., Viera, A. J., Busby‐Whitehead, J., & Hanson, L. C. (2010). Interventions to improve transitional care between nursing homes and hospitals: a systematic review. Journal of the American Geriatrics Society, 58(4), 777-782.

Leyenaar, J. K., Desai, A. D., Burkhart, Q., Parast, L., Roth, C. P., McGalliard, J., … &Gidengil, C. A. (2016). Quality measures to assess care transitions for hospitalized children. Pediatrics, 138(2), e20160906.

McDonagh, J. E., & Kelly, D. A. (2010).The challenges and opportunities for transitional care research. Pediatric transplantation, 14(6), 688-700.

Toles, M., Colon-Emeric, C., Asafu-Adjei, J., Moreton, E., & Hanson, L. C. (2016). Transitional care of older adults in skilled nursing facilities: A systematic review. Geriatric Nursing, 37(4), 296-301.

 
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Challenges in Transitional Care

/in /by

Challenges in Transitional Care

Florida National University

Robert Alonso

May 21, 2019

Introduction to the Problem

Increasing cases of patient readmissions as soon as they are discharged from hospitals have been on the rise thus indicating existing challenges in the provision of transitional care. Transitional care refers to the provision of continuous treatment to the patients as they move from one health care facility to the next or from the health facilities to their homes. According to a study conducted by Ortiz in 2015, it was established that “35.6% of hospital re-admissions within 30 days of discharge are of elderly patients aged 75-84” (Ortiz, 2019). These statistics indicate existing disparities in the provision of transitional care thus resulting in the worsened conditions of the patients as soon as they go home. Ortiz nonetheless establishes that most caregivers admit to not having adequate knowledge and experience on how to deal with the patients as soon as they are discharged from hospitals (Ortiz, 2019). In most cases, elderly patients suffering from acute conditions tend to be the most vulnerable and easily fall ill once transitional care is missing. Further according to Storm, “A majority of the deaths involving elderly patients in home-based and community-based care were as a result of lack of additional transitional care” (Storm et. al., 2014). Similar results are echoed by Ye et. al., (2016), where in China policies were introduced in 2012, hindering the provision of transitional care to patients by the nurses, and as a result the practice saw at least 33% of the elderly patients decline in their overall well-being and functioning once left under the care of their caregivers. Therefore, such statistics indicate that home-based care is often marked by a lack of professional monitoring and also the transition from a medical setting to a home setting often results in medication mix-up which negatively imposes on the health of the elderly patients.

Clearly Identify the Problem

Transitional care is marked by a lack of specialized nursing interventions which results to the high rates of hospital readmissions especially among the elderly patients suffering from acute conditions. Also, there lacks clear communication during the handing off of the patients to the caregivers, hence resulting in increased confusion on the part of the care givers on how to take care of the patients which results in their worsening conditions (Morphet et. al., 2014). Additionally, a majority of the caregivers are not adequately trained on how to provide primary care to their patients and hence when left in their care, their condition does not get any better forcing them to be readmitted to hospitals. In other cases, the patients may lack caregivers to look after them hence requiring a present transitional nurse to help meet their medical needs, and once these nurses are absent then the well-being of the patients is compromised (Morphet et. al., 2014).

The existing challenges in transitional care are largely brought about by the lack of specialized nurses with skills and knowledge on professional transitional nursing care. According to Storm et. al., (2014), the health and well-being of the patients is threatened once there exist inconsistencies in the provision of transitional care. In most cases, unspecialized nurses are left to handle the transfer of the patients from one facility to the next which makes their situation worse, since such nurses are unaware of the significance of timely and comprehensive communication during the transition period. Moreover, when dealing with unspecialized nurses, there exist inconsistencies in the emergency department nurses and those in the ICU hence worsening the transition phase. Hence, the existence of unspecialized nurses adds to more confusion on the type of therapy required by the patients in their recovery phase hence resulting in more complications (Ortiz, 2019). Thus, the existence of specialized nurses in transitional care is key in ensuring the provision of high-quality transitional care and also in promoting the well-being of the patients.

Significance of the Problem to Nursing

The problem on transition care is significant to nursing since it illustrates the need for specialized nursing care as a means to overcome the existing inadequacies in transition care. Also, the problem is rooted in the nursing profession as it seeks to increase awareness on the importance of specialized nursing care during transitional care. The problem further establishes that the current nursing services involved in transition care are inadequate and that often patients are often sent home without lack of continuity care from professionals. The problem is also significant since it informs of the weaknesses in nursing communication, illustrating inconsistencies in the provision of comprehensive information to foster continuity care. Also, the problem makes it evident that poor professional coordination among the nurses comes in the way of transitional care hindering effective consultation of the provision of information among the nurses and to the caregivers. Consequently, the problem helps to illuminate the challenges encountered by nurses when providing their nursing roles among them ensuring that patients with no caregivers receive transitional care from them and also informing the caregivers on how to deal with patients. The problem is hence important in informing nurses on their shortcomings and informing them on how to enhance their nursing roles. Addressing transition care will help to improve the role of the nurses in providing care for their patients and hence it is essential that nurses acquire additional skills and education on how to provide transitional care to patients.

Purpose of the Research

The main purpose of the research is to enhance the quality of transitional care. Previous studies focused merely on the quality of health care provided to the general population while omitting the issues surrounding transitional care and as a result there lacks knowledge and awareness on transitional care hence resulting in the increased rates of patient readmissions. Therefore, my research on the topic is intended to provide adequate knowledge of the issues surrounding transitional care and to bring attention to the stakeholders on the significance of investing in the issue. Also, the research is intended to enlighten the nurses on their areas of weaknesses and to enlighten them on how they can improve their provision of transitional care. Another key purpose of the research is to push for the inclusion of transitional care in the nursing curriculum to help impact all nurses with adequate knowledge on how to go about the issue. Lastly, the research aims to create a platform for more future research on the same hence raising awareness on the severity of the issues on transitional care

Research Questions

The research will answer the following questions:

  1. What are the main challenges facing transitional care?
  2. How does unspecialized nursing impact on transitional care?
  3. What is the importance of specialized nursing in the provision of transitional care?

Master’s Essentials that Align with my Topic

Different master’s essentials align with my topic. For example, Essential II establishes that the quality of patient care is enhanced by effective organizational leadership, and in my topic, I have highlighted how challenges in leadership like communication and nurses’ corporation negatively impose on the patient well-being. Also, Essentials III aligns with my topic where it points out that inadequate specialized nursing is the root cause of all the shortcomings in the provision of health care and that master-level nurses should always be present in any nursing facility as they are fully aware on how to handle different patient needs. Likewise, my topic indicates that unspecialized nurses result in the provision of low-quality transitional care. Lastly, my topic aligns with Essential IX, which establishes that the master’s degree level nurses tend to have scientific understanding and also know how best to apply the knowledge to practice. The Essential further notes that such nurses can quickly influence the realization of positive health care outcomes. Similarly, my topic notes that unspecialized nurses cannot compare to the specialized nurses with a master’s education, where the unspecialized nurses are not well vast on the importance of transitional care while the specialized nurses can quickly influence better transitional care results because of their level of expertise and knowledge.

References

Morphet, J., Griffiths, D. L., Innes, K., Crawford, K., Crow, S., & Williams, A. (2014). Shortfalls in residents’ transfer documentation: Challenges for emergency department staff. Australasian Emergency Nursing Journal, 17(3), 98-105.

Ortiz, M. R. (2019). Transitional Care: Nursing Knowledge and Policy Implications. Nursing science quarterly, 32(1), 73-77.

Storm, M., Siemsen, I. M., Laugaland, K., Dyrstad, D., &Aase, K. (2014). Quality in transitional care of the elderly: Key challenges and relevant improvement measures. International journal of integrated care, 14(2).

Ye, Z. J., Liu, M. L., Cai, R. Q., Zhong, M. X., Huang, H., Liang, M. Z., &Quan, X. M. (2016). Development of the Transitional Care Model for nursing care in Mainland China: A literature review. International journal of nursing sciences, 3(1), 113-130.

 
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Challenges in Transitional Care

/in /by

Challenges in Transitional Care

Florida National University

Robert Alonso

May 21, 2019

Introduction to the Problem

Increasing cases of patient readmissions as soon as they are discharged from hospitals have been on the rise thus indicating existing challenges in the provision of transitional care. Transitional care refers to the provision of continuous treatment to the patients as they move from one health care facility to the next or from the health facilities to their homes. According to a study conducted by Ortiz in 2015, it was established that “35.6% of hospital re-admissions within 30 days of discharge are of elderly patients aged 75-84” (Ortiz, 2019). These statistics indicate existing disparities in the provision of transitional care thus resulting in the worsened conditions of the patients as soon as they go home. Ortiz nonetheless establishes that most caregivers admit to not having adequate knowledge and experience on how to deal with the patients as soon as they are discharged from hospitals (Ortiz, 2019). In most cases, elderly patients suffering from acute conditions tend to be the most vulnerable and easily fall ill once transitional care is missing. Further according to Storm, “A majority of the deaths involving elderly patients in home-based and community-based care were as a result of lack of additional transitional care” (Storm et. al., 2014). Similar results are echoed by Ye et. al., (2016), where in China policies were introduced in 2012, hindering the provision of transitional care to patients by the nurses, and as a result the practice saw at least 33% of the elderly patients decline in their overall well-being and functioning once left under the care of their caregivers. Therefore, such statistics indicate that home-based care is often marked by a lack of professional monitoring and also the transition from a medical setting to a home setting often results in medication mix-up which negatively imposes on the health of the elderly patients.

Clearly Identify the Problem

Transitional care is marked by a lack of specialized nursing interventions which results to the high rates of hospital readmissions especially among the elderly patients suffering from acute conditions. Also, there lacks clear communication during the handing off of the patients to the caregivers, hence resulting in increased confusion on the part of the care givers on how to take care of the patients which results in their worsening conditions (Morphet et. al., 2014). Additionally, a majority of the caregivers are not adequately trained on how to provide primary care to their patients and hence when left in their care, their condition does not get any better forcing them to be readmitted to hospitals. In other cases, the patients may lack caregivers to look after them hence requiring a present transitional nurse to help meet their medical needs, and once these nurses are absent then the well-being of the patients is compromised (Morphet et. al., 2014).

The existing challenges in transitional care are largely brought about by the lack of specialized nurses with skills and knowledge on professional transitional nursing care. According to Storm et. al., (2014), the health and well-being of the patients is threatened once there exist inconsistencies in the provision of transitional care. In most cases, unspecialized nurses are left to handle the transfer of the patients from one facility to the next which makes their situation worse, since such nurses are unaware of the significance of timely and comprehensive communication during the transition period. Moreover, when dealing with unspecialized nurses, there exist inconsistencies in the emergency department nurses and those in the ICU hence worsening the transition phase. Hence, the existence of unspecialized nurses adds to more confusion on the type of therapy required by the patients in their recovery phase hence resulting in more complications (Ortiz, 2019). Thus, the existence of specialized nurses in transitional care is key in ensuring the provision of high-quality transitional care and also in promoting the well-being of the patients.

Significance of the Problem to Nursing

The problem on transition care is significant to nursing since it illustrates the need for specialized nursing care as a means to overcome the existing inadequacies in transition care. Also, the problem is rooted in the nursing profession as it seeks to increase awareness on the importance of specialized nursing care during transitional care. The problem further establishes that the current nursing services involved in transition care are inadequate and that often patients are often sent home without lack of continuity care from professionals. The problem is also significant since it informs of the weaknesses in nursing communication, illustrating inconsistencies in the provision of comprehensive information to foster continuity care. Also, the problem makes it evident that poor professional coordination among the nurses comes in the way of transitional care hindering effective consultation of the provision of information among the nurses and to the caregivers. Consequently, the problem helps to illuminate the challenges encountered by nurses when providing their nursing roles among them ensuring that patients with no caregivers receive transitional care from them and also informing the caregivers on how to deal with patients. The problem is hence important in informing nurses on their shortcomings and informing them on how to enhance their nursing roles. Addressing transition care will help to improve the role of the nurses in providing care for their patients and hence it is essential that nurses acquire additional skills and education on how to provide transitional care to patients.

Purpose of the Research

The main purpose of the research is to enhance the quality of transitional care. Previous studies focused merely on the quality of health care provided to the general population while omitting the issues surrounding transitional care and as a result there lacks knowledge and awareness on transitional care hence resulting in the increased rates of patient readmissions. Therefore, my research on the topic is intended to provide adequate knowledge of the issues surrounding transitional care and to bring attention to the stakeholders on the significance of investing in the issue. Also, the research is intended to enlighten the nurses on their areas of weaknesses and to enlighten them on how they can improve their provision of transitional care. Another key purpose of the research is to push for the inclusion of transitional care in the nursing curriculum to help impact all nurses with adequate knowledge on how to go about the issue. Lastly, the research aims to create a platform for more future research on the same hence raising awareness on the severity of the issues on transitional care

Research Questions

The research will answer the following questions:

  1. What are the main challenges facing transitional care?
  2. How does unspecialized nursing impact on transitional care?
  3. What is the importance of specialized nursing in the provision of transitional care?

Master’s Essentials that Align with my Topic

Different master’s essentials align with my topic. For example, Essential II establishes that the quality of patient care is enhanced by effective organizational leadership, and in my topic, I have highlighted how challenges in leadership like communication and nurses’ corporation negatively impose on the patient well-being. Also, Essentials III aligns with my topic where it points out that inadequate specialized nursing is the root cause of all the shortcomings in the provision of health care and that master-level nurses should always be present in any nursing facility as they are fully aware on how to handle different patient needs. Likewise, my topic indicates that unspecialized nurses result in the provision of low-quality transitional care. Lastly, my topic aligns with Essential IX, which establishes that the master’s degree level nurses tend to have scientific understanding and also know how best to apply the knowledge to practice. The Essential further notes that such nurses can quickly influence the realization of positive health care outcomes. Similarly, my topic notes that unspecialized nurses cannot compare to the specialized nurses with a master’s education, where the unspecialized nurses are not well vast on the importance of transitional care while the specialized nurses can quickly influence better transitional care results because of their level of expertise and knowledge.

References

Morphet, J., Griffiths, D. L., Innes, K., Crawford, K., Crow, S., & Williams, A. (2014). Shortfalls in residents’ transfer documentation: Challenges for emergency department staff. Australasian Emergency Nursing Journal, 17(3), 98-105.

Ortiz, M. R. (2019). Transitional Care: Nursing Knowledge and Policy Implications. Nursing science quarterly, 32(1), 73-77.

Storm, M., Siemsen, I. M., Laugaland, K., Dyrstad, D., &Aase, K. (2014). Quality in transitional care of the elderly: Key challenges and relevant improvement measures. International journal of integrated care, 14(2).

Ye, Z. J., Liu, M. L., Cai, R. Q., Zhong, M. X., Huang, H., Liang, M. Z., &Quan, X. M. (2016). Development of the Transitional Care Model for nursing care in Mainland China: A literature review. International journal of nursing sciences, 3(1), 113-130.

 
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