Annotated Bibliography On Transitions Of Care Discussion Paper

Posted: December 29th, 2022

Annotated Bibliography On Transitions Of Care Discussion Paper

Module 2 Assignment 1: Annotated Bibliography on Transitions of Care An annotated bibliography is a combination of the words annotation and bibliography. An annotation is a set of notes, comments, or critiques. A bibliography is a list of references that helps a reader identify sources of information. An annotated bibliography, then, is a list of references that not only identifies the sources of information but also includes information such as a summary, a critique or analysis, and an application of those sources’ information. Module 2 Assignment 2 (due in Week 5) will be a paper on nurse leadership during transitions of care for two selected entities. In preparation for that paper, you will develop an Annotated Bibliography and submit it to your Instructor for feedback. To prepare: Select a transition of care (hospital, specialty care, rehabilitation, nursing home, homebound, etc.)Annotated Bibliography On Transitions Of Care Discussion Paper.


Use the Walden Library and other reputable academic resources to locate 5 scholarly resources on nurse leadership during this transition of care. Identify what constitutes effectiveness (i.e., cost, care management, best/effective providers, best setting, sustaining outcomes) for this transition of care within each setting. What evidence supports this transition of care or transition of care intervention? Review the Writing Center resources on annotated bibliographies and scholarly writing. Also review the Module 2 Assignment 1 Rubric for specific details about the requirements for your annotated bibliography. Assignment Create an annotated bibliography of the 5 scholarly resources you located on your selected transition of care. Follow the annotated bibliography format presented in the Writing Center resource. Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at All papers submitted must use this formatting Annotated Bibliography On Transitions Of Care Discussion Paper.

Healthcare providers offer healthcare services to clients in various locations, and nurse leaders assume the responsibility of guaranteeing a smooth transition from one environment to the other. Thus, the transition of care has remained a crucial activity that tends to come with plenty of difficulties that require nurse leadership and care coordination to guarantee an effective transition. Transferring a client from an acute inpatient unit to a home environment requires many actions and care coordination to avert client mishandling and sustain the required standards of care. Moreover, nurse leaders make sure that there is productive communication amongst the healthcare professionals, clients, and relatives. Hence, the transition of care from the hospital setting to a residential context is really essential, and nurse leaders have an obligation to teach family members caregiving skills and client medicines and dynamics that must be integrated to make sure patient-centered care and consistent quality of care to the client. Therefore, this article aims to offer an annotated bibliography on nurse leadership throughout the transition of care to home from hospital .as a result, the article will address how nurses integrate care coordination and their abilities to guarantee that there is continuous patient care with the anticipated level of care for optimum care and recuperation in a home environment Annotated Bibliography On Transitions Of Care Discussion Paper.

Annotated Bibliography

Camicia, M., & Lutz, B. J. (2016). Nursing’s role in successful transitions across settings. Stroke, 47(11), e246-e249.

In this article, Camicia & Lutz (2016) gave an overview of the role of the nurse in facilitating effective transitions between contexts. A major role is played by nurse leaders in making sure that patients get consistent care that meets the anticipated quality and standards of care even after they have been released from the hospital and are getting home care services, as per Camicia and Lutz (2016). Nurse leaders must make sure that there is clear communication amongst all parties concerned, including nurses, clients, and family members who offer nursing care services, in order to promote a smooth transition for everyone concerned.

As per the authors, a good transition of care is accomplished when there is care coordination, in which the client is cared for in accordance with the well-defined standards that govern when and how the client is released from the hospital setting. Consequently, the Institute of Medicine and the National Quality Forum have recognized transitioning from a clinic to a residential setting as a national matter of primary consideration. This is because the transition of care is a point of exchange where there is a significant risk of non-compliance with quality care protocols and poor client care, leading to poor health results.

The information included in this article is pertinent to the contemporary dialogue around nurse leadership in the care transition process. Nurse leadership throughout this critical task has been implemented in order to bridge these gaps and guarantee the continuation of top-quality patient-centered care, thereby decreasing readmission rates whilst simultaneously enhancing patient results for all patients. Nurse leaders, on the other hand, work with clients and their families to create a successful transition plan, as well as assessing various obstacles, such as financial constraints that prove it difficult for clients to buy quality medicine and nursing care from caregivers who offer home care services Annotated Bibliography On Transitions Of Care Discussion Paper.

Britton, M. C., Ouellet, G. M., Minges, K. E., Gawel, M., Hodshon, B., & Chaudhry, S. I. (2017). Care transitions between hospitals and skilled nursing facilities: perspectives of sending and receiving providers. The Joint Commission Journal on Quality and Patient Safety, 43(11), 565-572.

Britton et al. (2017) provided an insight into how safe healthcare services and quality are required from all healthcare institutions, regardless of their financial situation. According to the authors, the duty for guaranteeing that clients get safe patient care throughout the transition to home care and when at home falls on the shoulders of nurse leaders.

The article has solid points regarding the quality of care and patient safety. Britton et al. pointed out that quality of care and patient safety are ensured via contact amongst family members and nurse leaders, even when the client is getting care services outside the clinic.

The issues cited in this source are from The Joint Commission perspective, where patient safety and quality of care are regarded as the essential aspects that need to be considered throughout the transfer of care. As a result, The Joint Commission places emphasis on the standards of care given to patients during transitions of care, and nurse leaders have the responsibility of ensuring that appropriate standards of care are offered to clients throughout and following the transition of care.  This is accomplished via follow-ups, care coordination, and regular check-ins even after release, all of which contribute to better patient outcomes Annotated Bibliography On Transitions Of Care Discussion Paper.

Udod, S. A., & Lobchuk, M. (2017). The role of nurse leaders in advancing career communication needs across transitions of care: a call to action. Nursing Leadership, 30(1), 47-55.

The concept ‘call to action is used in this source to indicate that nurse leaders have a responsibility to engage family members and other healthcare professionals throughout the transition of care from a clinical context to a home environment. According to Udod  & Lobchuk (2017), in order to ensure that the client’s health is monitored and treatment is given in accordance with the progress, nurse leaders are required to sustain communication with the family. Moreover, Udod  & Lobchuk determine that nurse leaders guarantee that they collaborate with caregivers to enhance the quality of care, resulting in a reduction in patient complaints,  a reduction in readmissions, an improvement in patient safety, and an improvement in patient outcomes.

Udod  & Lobchuk’s (2017) sentiments in this article are relevant to nursing leadership, which is a strength. They are for the idea that nurse leaders’ participation in the transition of care process is critical since it ensures that family members are informed on how to care for a patient in the home environment while taking into consideration the client’s diet, if one is required, and guaranteeing patient-centered care, which improves patient outcomes, among other things.

This article is applicable to nursing care because it also calls for communication throughout care coordination between family members and healthcare professionals, which aids in the assessment of vital signs and the assuring of medication adherence, all of which contribute to better outcomes for patients.

Bucknall, T. K., Hutchinson, A. M., Botti, M., McTier, L., Rawson, H., Hewitt, N. A., … & Chaboyer, W. (2016). Engaging patients and families in communication across transitions of care: an integrative review protocol. Journal of advanced nursing, 72(7), 1689-1700.

Bucknall et al. (2016) claim that communication is important in the execution of healthcare operations in medical institutions because inadequate communication results in misunderstanding of information, which leads to a variety of problems. According to the authors, effective and adequate communication means that clients are properly taken care of, get the appropriate diagnoses, and receive the appropriate prescriptions for the appropriate patients in the appropriate dosages Annotated Bibliography On Transitions Of Care Discussion Paper.


The issue about communication, as pointed out by Bucknall et al. (2016), is relevant to nurse leaders as they should make sure that healthcare professionals have access to accurate patient information that will assist them in providing high-quality nursing care. In a similar vein, nurse leaders should promote appropriate communication and involvement amongst clients and their families throughout the transition of care in order to provide optimum care to clients.

Bucknall et al. demonstrate that it is critical to include family and patient in the healthcare process since family members perform an essential role in delivering patient-centered care and therefore enhancing patient outcomes. As a healthcare provider, I can apply this knowledge in caring for my clients. Other benefits of involving family and patient include lower readmission rates and lower hospital expenditures overall.

Mansukhani, R. P., Bridgeman, M. B., Candelario, D., & Eckert, L. J. (2015). Exploring transitional care: evidence-based strategies for improving provider communication and reducing readmissions. Pharmacy and Therapeutics, 40(10), 690.

This article delves into the importance of developing a patient treatment plan when a client is moved from a hospital environment to a homecare context. When patients are transitioning from the clinic to a homecare environment, nurse leaders are critical in the development of a home treatment plan for the client’s specific needs.

The authors present a relevant point of view in describing the significance of the development. This is because a patient treatment plan guarantees that the clients receive consistent care that meets the anticipated standards and levels of quality. Additionally, according to Mansukhani et al. (2015), care coordination is necessary since it guarantees that the client is properly assessed for any health problems that may lead to further difficulties; as a result, nurses play an important role in the implementation of care coordination.

Overall I can apply the knowledge gained from this article by guaranteeing that appropriate handoffs are completed, therefore minimizing omissions and medical mistakes, as well as enhancing patient outcomes via the provision of continuous standard patient care.


Nurse leaders play important responsibilities throughout the transition of the care process because they guarantee adequate and appropriate communication, as well as client and family involvement throughout the entire process Annotated Bibliography On Transitions Of Care Discussion Paper

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