Nursing experience of inter-hospital referral in hierarchical medical system: a qualitative research

Objective To explore the nursing experience of inter-hospital referral in hierarchical medical system, so as to provide references for further improvement in patient referral. Methods From March to April 2017, a total of 16 emergency nurses from a Class Ⅲ Grade A hospital were selected by purposive sampling method. Semi-structured interviews were conducted using the method of phenomenology in qualitative research, and Nvivo 8.0 qualitative analysis software was applied for data collation and analysis. Results In the current stage, the factors causing the poor access of patient referral could be summarized in the evaluation, communication and medical documents. There were 7 themes of it: lack of assessment, poor observation of patients' conditions, poor notification, poor communication between hospitals, lack of effective handover, incompleteness of the medical documents, and irregular of the medical documents. Conclusions It is necessary to strengthen the skills of evaluation and communication of medical staff in the hierarchical medical system. At the same time, standardizing medical documents and improving the efficiency of inter-hospital referral were to improve patients' referral and ensure patients safety. Key words: Progressive patient care; Patient transfer; Disease information transition; Qualitative research