Impact of Structured Discharge Planning on Readmission Rates, Caregiver Preparedness, and Continuity of Care in Pediatric Nursing

Introduction: Hospital discharge represents a critical juncture in pediatric care. Incomplete or poorly structured discharge planning can result in adverse outcomes, including unnecessary readmissions, increased caregiver stress, and fragmented follow-up care. Structured discharge planning has been proposed as an evidence-based approach to improve the transition from hospital to home for children. However, its overall effectiveness across diverse settings remains unclear. This systematic review aimed to evaluate the impact of structured discharge planning interventions on hospital readmission rates, caregiver preparedness, and continuity of care within pediatric nursing practice. Methods: A comprehensive search was conducted in PubMed, CINAHL, Scopus, and Web of Science for studies published between January ۲۰۰۰ and April ۲۰۲۵. Search terms combined MeSH and free-text keywords related to "pediatric," "structured discharge planning," "nursing," "readmission," and "continuity of care." Eligible studies included randomized controlled trials, quasi-experimental studies, and observational research focusing on structured discharge programs in pediatric populations. Data extraction and quality assessment were conducted independently by two reviewers in accordance with PRISMA guidelines. Findings were synthesized narratively and, where applicable, through meta-analysis. Results: From ۱,۲۳۶ articles initially identified, ۲۷ studies met the inclusion criteria comprising ۱۴ randomized controlled trials, ۸ quasi-experimental studies, and ۵ observational cohoits representing a total sample of ۸,۴۶۲ pediatric patients across multiple care settings. Meta-analysis of ۱۸ studies reporting hospital readmission rates showed a pooled relative risk reduction of ۲۸% in structured discharge planning groups compared with usual care. Caregiver preparedness, measured using validated readiness-for-discharge scales, revealed a mean increase of ۱.۲-۱.۸ points on a ۵-point Likert scale, indicating markedly improved confidence in post-discharge care. Continuity of care outcomes indicated that children enrolled in structured discharge programs were twice as likely to attend scheduled follow-up appointments and showed a ۲۲-۳۰% improvement in adherence to medication and care plans. Qualitative data from six mixed-methods studies highlighted additional benefits, including reduced caregiver anxiety, improved communication between families and healthcare teams, and enhanced coordination with community health providers. Conclusion: Structured discharge planning in pediatric nursing offers substantial benefits in reducing hospital readmissions, improving caregiver readiness, and strengthening continuity of care. Standardizing intervention components and outcome metrics will be essential for broader implementation and for enabling cross-study comparisons. Future research should explore long-term outcomes and cost-effectiveness.

کلیدواژه ها:

Pediatric Nursing ، Discharge Planning ، Hospital Readmission ، Caregiver Preparedness ، Continuity of Care