Nursing Open · 3 authors, 7 centres
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This ethnographic fieldwork study investigated the facilitators and inhibitors of patient transfer decisions for traumatic brain injury across three care stages. The central result is that transfer decisions were made by different groups (physicians, collaborative teams, non-clinical staff) at different stages, with delays and inefficiencies occurring notably in the final, municipal rehabilitation stage.
The study used ethnographic fieldwork with participant observation and interviews at three Danish sites representing acute, subacute, and stable stages of the traumatic brain injury trajectory. Findings indicated that transfer decisions in the acute stage were physician-led and driven by bed availability, posing a risk of premature transfer. In the subacute stage, decisions were collaborative among healthcare professionals and family, often allowing for beneficial extended rehabilitation. In the final municipal rehabilitation stage, decisions were made by non-clinical vocational nurses who lacked the medical and bureaucratic authority to execute them effectively, leading to delays.
