سامانه همایش های دانشگاه آزاد اسلامی واحد نجف آباد

صفحه اصلی / اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

A Systematic Review of Nursing Strategies Affecting Safe Hospital-to-Home Transition in Diabetic Patients

نویسندگان :

Mahtab Ghanbari Rad¹ Azadehalsadat Hosseini dastgerdi²

1- دانشکده علوم پزشکی گراش 2- دانشگاه ازاد واحد نجف اباد

کلمات کلیدی :

Diabetes Mellitus،Transitional Care،Discharge Planning،Nursing Interventions،Hospital Readmission،Patient Safety

چکیده :

Abstract Introduction: The transition of patients with diabetes from hospital to home is a critical phase of care associated with increased risks of medication errors, glycemic instability, poor treatment adherence, and hospital readmission. Evidence indicates that a substantial proportion of adverse events and readmissions occur within the first 30 days after discharge. Nurses play a pivotal role in patient education, care coordination, discharge planning, and post-discharge follow-up. This systematic review aimed to synthesize existing evidence on nursing strategies that promote safe hospital-to-home transition in diabetic patients and to evaluate their clinical and healthcare outcomes. Methods: This study was conducted as a systematic review. PubMed, Scopus, Web of Science, CINAHL, and Cochrane Library databases were searched up to 2025. Keywords related to diabetes, transitional care, discharge planning, and nursing interventions were used. Clinical trial, quasi-experimental, and intervention studies that examined nursing strategies during the transition period were included in the study. Findings: Recent evidence highlights the need for a structured, multidisciplinary, and continuity-focused approach to ensure safe hospital-to-home transition in diabetic patients. Nurse-led transitional care models within interdisciplinary teams have been shown to reduce 30-day readmissions, improve glycemic control, and enhance treatment adherence. Key interventions include comprehensive discharge assessment, medication reconciliation, self-management education, individualized care planning, and proactive post-discharge follow-up via telephone, home visits, or telehealth. Integrating systematic assessment, patient-centered education, and active follow-up demonstrates the most. Conclusion: The transition of diabetic patients from hospital to home is a high-risk process that cannot be effectively managed through traditional acute-oriented approaches alone. Evidence supports the need for structured, continuity-focused transitional care models. Nurses play a central role in leading this process through comprehensive assessment, patient education, medication management, and post-discharge follow-up. Nurse-led transitional care interventions are associated with reduced readmissions and improved clinical outcomes. Institutionalizing standardized nurse-led transitional care programs within hospitals and primary healthcare networks is a practical and effective strategy to enhance patient safety and improve the quality of diabetes care.