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Using Transitional Care Model in Nursing


As we have already stated in previous parts of our research, the Transitional Care Model provides nurses with an opportunity to monitor patients’ states and ensure that they will have a chance to communicate to a healthcare specialist at any moment. It will obviously contribute to the increased efficiency of the whole sector and guarantee better final outcomes. However, at the same time, the transition might have different effects on patients as several investigations show that elderly patients or patients with heart failure might not benefit from the usage of this very practice (Laugaland, Aase, & Barach, 2012). For this reason, we are sure that additional research related to the nature of the Transitional Care Model and its impact both on nurses and patients is needed. It will help to trace the alterations in the relations between health workers and patients and determine whether obtained results might be used to support the further implementation of the practice or not.

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In this regard, the given section is focused on the discussion of the main results obtained in the course of the study. It was organized in the most efficient way that provided us with the crucial information needed to make a certain conclusion. A specific questionnaire that should be distributed between nurses who care for patients with cardiologic problems was created. The local hospitals were chosen as the main places where the study could be conducted. These medical institutions were chosen accidentally to avoid any negative impact on the appearance of subjective data. We should say that the usage of the given methodology contributed to the acquisition of the credible data that could be explored to make conclusions about the overall efficiency of the suggested measures and perspectives related to the implementation of the Transitional Care Model. The data obtained with the help of surveys could be described as relevant and topical (Faltin, Kenett, & Ruggeri, 2012).


We used random sampling to attain the increased credibility of findings and avoid any factors that might deteriorate the final results of the study. Nurses working in the above-mentioned medical institutions were suggested to complete the survey to help to investigate the Transitional Care Model and determine its efficiency in terms of this very environment. Moreover, we also cooperated only with nurses who worked with patients characterized by problems with the heart. Analyzing the results of the study, we could say that the usage of this very sampling methodology turned out to be a good choice. It provided us with credible and relevant data that could be used in the discussion. Moreover, the involvement of 100 participants (72% females and 22% males) with a considerably vast experience (not less than two years) resulted in improved final outcomes. At the moment, we could state that the given sampling methodology could be recommended for the following researchers devoted to this very issue. Additionally, we also used statistical analysis of the most important showings in terms of the wide use of the Transitional Care Model (TCM), patients outcomes, and risks.


Therefore, the following results were obtained. Using the above-mentioned surveys, we could state that the majority of respondents (78) admit the great practical use of the TCM in terms of the health care sector. These respondents stated that adherence to this very model might decrease the risk of negative outcomes or the development of numerous complications. Moreover, respondents also admitted the great positive impact TCM had on the relations between patients and health workers. The nurses who took part in the investigation were sure that the usage of the above-mentioned model might obviously be useful, but only if additional training had been introduced (Toles et al., 2012). Some respondents also showed the lack of the background knowledge needed for the efficient implementation of this very practice. However, the survey also indicated that there still were several problems with the given model. Some patients were not able to understand its basic ideas and follow the main rules. Especially complex the situation was in patients characterized by critical conditions as they were hardly able to explore TCM and enjoy its benefits.

Furthermore, investigating statistical data related to the implementation of TCM, we could state that all hospitals that took part in our study demonstrated positive shifts in their functioning. The adherence to the suggested model contributed to the enhanced final results and positive outcomes. The number of cases when the lack of communication or inability to get in touch with a health worker decreased significantly. Furthermore, the usage of this approach also contributed to the improved image of medical establishments. However, the same statistical analysis shows that several problems remain. The implementation of TCM is a long-term process that demands a specific setting, and it is impossible to reorganize the functioning of a health care unit instantly. For this reason, the majority of problems that appeared in the course of the investigation could be related to the inability to understand the nature of the practice and its main principles. That is why the need for additional training becomes obvious.

Finally, delving into another aspect of TCM implementation, we could also state that the analysis of the statistical data shows that the bigger part of patients also admits the positive impact of this very practice and its contribution to their improved final results. The investigation also shows that patients address health specialists on earlier stages of the disease, and it contributes to the decrease of the overall course of treatment and reduces the risk of complications (Rennke et al., 2013). Furthermore, our research included the elderly population and their relations with family members in terms of TCM. The majority of respondents admitted the fact that the improved mutual understanding should be stated. That is why the beneficial impact of TCM on patients and their family members should be admitted (Hirshman et al., 2015). Additionally, speaking about risks assessment, we could also provide the fact that the elimination of several crucial risk factors could be admitted. For this reason, the positive impact of TCM in the outlined medical units could hardly be doubted.


Besides, the above-mentioned results provide the ground for discussion. As it has already been stated, several researchers tend to doubt the efficiency of TCM because of the lack of understanding and other crucial reasons. That is why the given investigation was focused on the analysis of the most important statistical, qualitative, and quantitative data to determine the possible impact of this practice. Having conducted the research, we could state that the majority of the respondents agree that TCM could be used to improve final outcomes and guarantee that patients will have an opportunity to communicate to a health worker to solve the most crucial problems. However, there are still several issues related to this very question.

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The lack of competence, background knowledge, or understanding of TCMs basic concepts, both inpatients and health workers, might result in negative final results. For this reason, the necessity of additional training to mitigate the above-mentioned negative impact and eliminate the majority of risk factors becomes obvious. Furthermore, the investigation of the basic aspects related to the implementation of the given practice in terms of the suggested medical units shows that patients have a positive attitude to alterations caused by the reorganization of hospitals. The improved understanding of the basic concerns of the given model is a key to the final success. In this regard, the work aimed at the enhanced comprehending of the most crucial aspects of the given study becomes crucial. In case the level of education of patients grows, significant improvement of final outcomes will obviously be noted.


Altogether, having conducted the given study, we came to the following conclusions. First, the majority of nurses who completed the survey agreed that the usage of TCM could be considered one of the factors resulting in the improved final results. Moreover, they also accepted the idea that further exploration of the given practice will help to make the cooperation between nurses and patients more efficient. The analysis of the most relevant statistical data also shows that the tendency towards the positive shifts in the outlined medical units could be admitted. However, there are still several problematic areas that should be given attention. First of all, it is the lack of an improved understanding of TCM and its basic assumptions. For this reason, the implementation of additional training to improve the situation and attain better final outcomes might be recommended as one of the possible ways to solve the problem and guarantee improved final results.


Faltin, F., Kenett, R., & Ruggeri, F. (2012). Statistical methods in healthcare (1st ed.). Chichester, England: Wiley.

Hirshman, K., Shaid, E., McCauley, K., Pauly, M., & Naylor, M. (2015). Continuity of care: The Transitional Care Model. Online Journal of Issues in Nursing, 20(3), 1-12.

Laugaland, K., Aase, K., & Barach, P. (2012). Interventions to improve patient safety in transitional care–a review of the evidence. Work, 41(1), 2915-2924.

Rennke, S., Nguyen, O. K., Shoeb, M. H., Magan, Y., Wachter, R. M., & Ranji, S. R. (2013). Hospital-initiated transitional care interventions as a patient safety strategy: A systematic review. Annals of Internal Medicine, 158(5), 433-440.

Toles, M., Barroso, J., Colón-Emeric, C., Corazzini, K., McConnell, E., & Anderson, R. (2012). Staff interaction strategies that optimize delivery of transitional care in a skilled nursing facility. Family & Community Health, 35(4), 334-344.

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