Title Nursing staff and allied health professionals perceptions of delayed discharges from a specialist palliative care unit.

Background Discharge delays from specialist palliative care units are a common problem for patients. A delay in discharge, for whatever reason, can have significant implications for patients, and can mean that they are not cared for in their preferred place. There has been little research looking specifically at discharge delays from specialist palliative care units. Nursing staff and allied health professionals are often at the forefront of discharge planning, and little is known on their beliefs about this.

Aim To investigate the perceptions of nursing staff and allied health professionals about discharge delays from a specialist palliative care unit.

Methods The participants (nursing staff and allied health professionals) worked in a specialist palliative care unit in South Central England, and were involved in discharge planning for inpatients. The critical incident technique was used as the methodology. One-to-one interviews were audio taped, and analysed by the process of thematic analysis. Six participants were interviewed in total (five nursing staff and one allied health professional). The critical incident was defined as the ‘delayed discharge’, and participants talked about actual cases where a patient's discharge from the unit had been delayed.

Results The results were broadly split into six themes: patient and family issues, staff issues, communication, community care, equipment and ethical issues. Communication was raised so frequently by participants and was so pervasive that it was separated into a stand-alone theme.

Conclusions The results illustrate the complexities of the discharge planning process and discharge delays, and there is unlikely to be a single causative factor in a patient's delayed discharge. It is a source of distress to patients, families and staff. Practical issues need to be addressed, and communication is vital at all stages.