Post-Acute Care Transitions Should be Facilitated by Rehab Nurses

A new white paper asserts that successful post-acute care (PAC) transitions for individuals with disabling conditions must be facilitated by nurses with rehabilitation nursing training, knowledge, and experience. The Association of Rehabilitation Nurses (ARN) released "Essential Role of the Rehabilitation Nurse in Facilitating Care Transitions" in November and it was recently covered by Advanced Healthcare Network for Nurses.

According to the white paper, rehabilitation nurses are defined by a unique skill set, which includes knowledge and understanding required to manage the care of patients with acute or chronic illnesses and conditions that cause disability. Their expertise in leading teams that develop and implement patient/family-centered interventions and evaluate outcomes is vital to providing the care these patients need, according to the paper.

Recommendations include:

  • Involving rehabilitation nurses in national policy decisions, including as members of committees and technical expert panels.
  • Conducting studies to evaluate the impact of rehabilitation nurses on the health care delivery system. Research funded by federal agencies that compares payments and quality models, and evaluates of value-based payment models. 
  • Including rehabilitation nurses on Technical Expert Panels that assess ideas for developing new care coordination measures, including transitional care, to evaluate the quality of care coordination for individuals with disabilities.

An INQRI-funded study, “Nursing Care Quality in Acute Care Hospitals: New Linkages to Patient Outcomes,” examined whether increases in nurse staffing and skill mix improve hospital performance, enhance patient perceptions of nursing performance, and improve overall nursing performance. The study found that when patients were asked about aspects of care in which nurses functioned independently, there were more consistent, statistically significant correlations between patients' assessments of the quality of their hospital care and nurse staffing. The study was led by Arlyss Anderson Rothman and Adams Dudley.