Experiences of discharge planning practices among Indonesian nurses: A qualitative study


discharge planning
patient readmission

How to Cite

Kurniawan, T., Nilmanat, K., Boonyasopun, U., & Ganefianty, A. (2023). Experiences of discharge planning practices among Indonesian nurses: A qualitative study. Belitung Nursing Journal, 9(6), 520–529. https://doi.org/10.33546/bnj.2980
Google Scholar

Link to Google Scholar

Funder - Crossref Registry

Accepted for publication: 2023-11-22
Peer reviewed: Yes

Related articles in

Search Relations - Article by Author(s)

Share this article on:


Background: Discharge planning is vital to preventing hospital readmission, and nurses play a key role. The COVID-19 pandemic has posed challenges to hospital services that may persist or recur. Therefore, exploring nurses’ experiences with discharge planning practices before and during this pandemic is crucial.

Objective: This study aimed to describe the experiences of discharge planning practices among nurses at an Indonesian tertiary hospital before and during the COVID-19 pandemic.

Methods: A qualitative descriptive study design was used. Telephone interviews were conducted to collect data among ten nurses from March 2019 and continued between December 2020 and August 2021. Content analysis was done for data analysis.

Results: Two main themes emerged: 1) Challenges in discharge planning practices and 2) Perceived discharge planning as a professional responsibility. Implementing the inpatient ward fusion policy as part of the hospital’s pandemic response presented greater challenges to nurses in coordinating care and performing discharge planning. Fear of COVID-19 infection, social distancing measures, and using personal protective equipment also affected how nurses delivered discharge education during the pandemic. However, the nurses sensed a greater responsibility to ensure the maintenance of essential components of discharge planning procedures to guarantee the patient’s capability to perform self-care at home.

Conclusion: Nurses viewed discharge planning practices as their responsibility and continued them during the pandemic despite facing various challenges. In addition to recognizing the significance of nurses’ roles in discharge planning practices and overall patient care, it is crucial to anticipate and address the diverse working patterns and styles among healthcare professionals in unified wards, ensuring effective coordination.


Supporting Agencies

This study was supported by the Thailand’s Education Hub for the Southern Region of ASEAN Countries (THE-AC) Scholarship from Prince of Songkla University, Thailand


Copyright (c) 2023 Titis Kurniawan, Kittikorn Nilmanat, Umaporn Boonyasopun, Amelia Ganefianty

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Total views 497 [Abstract: 189 | PDF: 297 | XML: 11 ]


Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

The authors had no conflict of interest to declare.


Heartfelt thanks are extended to every contributor to this study, particularly to participants who shared valuable information and their experiences on practicing discharge planning during the pandemic situation. Sincere gratitude was also sent to the hospital director, who permitted the team to conduct this study, and the ward head nurse, who acted as a gatekeeper and helped us complete the study during the pandemic. Moreover, our gratitude goes to the Prince of Songkla University, Thailand, for supporting this work with the Thailand’s Education Hub for the Southern Region of ASEAN Countries (THE-AC) Scholarship.

Authors’ Contributions

Conceptualization, Methodology, Drafting the manuscript (TK, KN, and UB); Data analysis (TK, AG, KN, and UB); Critical revisions for important intellectual content (TK and KN). All authors have read and agreed to the final version of the manuscript.

Data Availability

The datasets generated during and analyzed during the current study are available from the corresponding author upon reasonable request.

Declaration of Use of AI in Scientific Writing

Nothing to declare.


Agerholm, J., Jensen, N. K., & Liljas, A. (2023). Healthcare professionals’ perception of barriers and facilitators for care coordination of older adults with complex care needs being discharged from hospital: A qualitative comparative study of two Nordic capitals. BMC Geriatrics, 23(1), 32. https://doi.org/10.1186/s12877-023-03754-z

Alberti, T. L., & Nannini, A. (2013). Patient comprehension of discharge instructions from the emergency department: A literature review. Journal of the American Academy of Nurse Practitioners, 25(4), 186-194. https://doi.org/10.1111/j.1745-7599.2012.00767.x

An, D. (2015). Cochrane review brief: Discharge planning from hospital to home. Online Journal of Issues in Nursing, 20(2), 13-13. https://doi.org/10.3912/OJIN.Vol20No02CRBCol01

Asmuji, A. (2018). Implementation of discharge planning in hospital inpatient room by nurses. Jurnal Ners, 13(1), 106-113. http://dx.doi.org/10.20473/jn.v13i1.5942

Bajorek, S. A., & McElroy, V. (2020). Discharge planning and transitions of care. Patient Safety Network PSNet. https://psnet.ahrq.gov/primer/discharge-planning-and-transitions-care

de Jong, W., Rusli, M., Bhoelan, S., Rohde, S., Rantam, F. A., Noeryoto, P. A., Hadi, U., Gorp, E. C. M. v., & Goeijenbier, M. (2018). Endemic and emerging acute virus infections in Indonesia: an overview of the past decade and implications for the future. Critical Reviews in Microbiology, 44(4), 487-503. https://doi.org/10.1080/1040841X.2018.1438986

del Rio, C., & Malani, P. N. (2022). COVID-19 in 2022—The beginning of the end or the end of the beginning? JAMA, 327(24), 2389-2390. https://doi.org/10.1001/jama.2022.9655

Drabble, L., Trocki, K. F., Salcedo, B., Walker, P. C., & Korcha, R. A. (2016). Conducting qualitative interviews by telephone: Lessons learned from a study of alcohol use among sexual minority and heterosexual women. Qualitative Social Work, 15(1), 118-133. https://doi.org/10.1177/1473325015585613

Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x

First-Williams, J. C. (2019). Educating staff nurses for successful patient discharge [Doctoral Dissertation, Walden University]. Minneapolis, Minnesota.

Gane, E. M., Schoeb, V., Cornwell, P., Cooray, C. R., Cowie, B., & Comans, T. A. (2022). Discharge planning of older persons from hospital: comparison of observed practice to recommended best practice. Healthcare, 10(2), 202. https://doi.org/10.3390/healthcare10020202

Ganefianty, A., Songwathana, P., & Nilmanat, K. (2021). Transitional care programs to improve outcomes in patients with traumatic brain injury and their caregivers: A systematic review and meta-analysis. Belitung Nursing Journal, 7(6), 445-456. https://doi.org/10.33546/bnj.1592

Gao, P., Zhang, X., Zhang, S., Yu, Y., Zhang, Y., Wang, L., Luo, W., Xiang, B., & Ma, J. (2022). COVID-19 persists: Current risk of a recurrence of the epidemic in China. Journal of Infection, 84(4), 579-613. https://doi.org/10.1016/j.jinf.2021.12.021

Gonçalves Bradley, D. C., Lannin, N. A., Clemson, L. M., Cameron, I. D., & Shepperd, S. (2016). Discharge planning from hospital. Cochrane Database of Systematic Reviews(1), CD000313. https://doi.org/10.1002/14651858.CD000313.pub5

Graham, J., Gallagher, R., & Bothe, J. (2013). Nurses' discharge planning and risk assessment: Behaviours, understanding and barriers. Journal of Clinical Nursing, 22(15-16), 2338-2346. https://doi.org/10.1111/jocn.12179

Hardivianty, C. (2017). Evaluasi pelaksanaan discharge planning di Rumah Sakit PKU Muhammadiyah Gamping Yokyakarta [Evaluation of discharge planning in PKU Muhammaditah Hospital Gamping Yogyakarta]. Proceeding Health Architecture, 1(1), 21-34.

Hayajneh, A. A., Hweidi, I. M., & Abu Dieh, M. W. (2020). Nurses' knowledge, perception and practice toward discharge planning in acute care settings: A systematic review. Nursing Open, 7(5), 1313-1320. https://doi.org/10.1002/nop2.547

Hickling, M. T., & Barnett, S. D. (2022). Psychological impact of COVID‐19 on nursing personnel: A regional online survey. Journal of Advanced Nursing, 78(9), 3025-3033. https://doi.org/10.1111/jan.15339

Hoffman, J. L., & Cowdery, J. E. (2022). Interprofessional education and collaboration in public health: a multidisciplinary health professions IPE project. Journal of Public Health, 30, 1095–1099. https://doi.org/10.1007/s10389-020-01381-1

Huerta González, S., Selva-Medrano, D., López-Espuela, F., Caro-Alonso, P. Á., Novo, A., & Rodríguez-Martín, B. (2021). The psychological impact of COVID-19 on front line nurses: A synthesis of qualitative evidence. International Journal of Environmental Research and Public Health, 18(24), 12975. https://doi.org/10.3390/ijerph182412975

Ibrahim, H., Harhara, T., Athar, S., Nair, S. C., & Kamour, A. M. (2022). Multi-disciplinary discharge coordination team to overcome discharge barriers and address the risk of delayed discharges. Risk Management and Healthcare Policy, 15, 141-149. https://doi.org/10.2147/RMHP.S347693

International Council of Nurses [ICN]. (2020). International Council of Nurses Guidelines on Advanced Practice Nursing 2020. https://www.icn.ch/system/files/documents/2020-04/ICN_APN%20Report_EN_WEB.pdf

Jackson, C., Shahsahebi, M., Wedlake, T., & DuBard, C. A. (2015). Timeliness of outpatient follow-up: An evidence-based approach for planning after hospital discharge. The Annals of Family Medicine, 13(2), 115-122. https://doi.org/10.1370/afm.1753

Jehloh, L., Songwathana, P., & Sae-Sia, W. (2022). Transitional care interventions to reduce emergency department visits in older adults: A systematic review. Belitung Nursing Journal, 8(3), 187-196. https://doi.org/10.33546/bnj.2100

Jehosua, W. A., Kakerissa, N., Pangaribuan, R. N., & Eka, N. G. A. (2023). Effect of an educational intervention program on discharge planning for nurses and midwives. Enfermería Clínica, 33, S33-S37. https://doi.org/10.1016/j.enfcli.2023.01.005

Kang, E., Tobiano, G., Chaboyer, W., & Gillespie, B. (2020). Nurses' role in delivering discharge education to general surgical patients: A qualitative study. Journal of Advanced Nursing, 76(7), 1698-1707. https://doi.org/10.1111/jan.14379

Karam, M., Brault, I., Van Durme, T., & Macq, J. (2018). Comparing interprofessional and interorganizational collaboration in healthcare: A systematic review of the qualitative research. International Journal of Nursing Studies, 79, 70-83. https://doi.org/10.1016/j.ijnurstu.2017.11.002

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. California: Sage Publications.

Loerinc, L. B., Scheel, A. M., Evans, S. T., Shabto, J. M., O'Keefe, G. A., & O'Keefe, J. B. (2021). Discharge characteristics and care transitions of hospitalized patients with COVID-19. Healthcare, 9(1), 100512. https://doi.org/10.1016/j.hjdsi.2020.100512

Lundereng, E. D., Dihle, A., & Steindal, S. A. (2020). Nurses’ experiences and perspectives on collaborative discharge planning when patients receiving palliative care for cancer are discharged home from hospitals. Journal of Clinical Nursing, 29(17-18), 3382-3391. https://doi.org/10.1111/jocn.15371

Mahendradhata, Y., Andayani, N. L. P. E., Hasri, E. T., Arifi, M. D., Siahaan, R. G. M., Solikha, D. A., & Ali, P. B. (2021). The capacity of the Indonesian healthcare system to respond to COVID-19. Frontiers in Public Health, 9, 649819. https://doi.org/10.3389/fpubh.2021.649819

McLean, J., Clark, C., McKee, A., Legue, S., Cocking, J., Lamarche, A., Heerschap, C., Morris, S., Fletcher, T., & McKee, C. (2022). Pandemic responsiveness in an acute care setting: a community hospital’s utilization of operational resources during COVID-19. Journal of Multidisciplinary Healthcare, 1309-1321. https://doi.org/10.2147/JMDH.S361896

Ministry of Health Indonesia. (2022). First MonkeyPox case in Indonesia (in Bahasa). Sehat Negeriku. https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20220820/3140968/kasus-monkeypox-pertama-di-indonesia-terkonfirmasi-2/

Ministry of Health Indonesia, & UNICEF. (2020). Report of rapid health assessment: Essential health services during the Covid-19 pandemic in Indonesia. https://www.unicef.org/indonesia/media/5361/file/Report%20of%20rapid%20essential%20health%20service%20assessment.pdf

Morse, J. M. (2015). “Data Were Saturated . . . ”. Qualitative health research, 25(5), 587-588. https://doi.org/10.1177/1049732315576699

Muliantino, M. R., Huriani, E., Krisdianto, B. F., Sarfika, R., Yesni, M., Sulistyowati, E., Wahyuningtyas, K., Sucipto, U., Sukarna, R. A., & Prasetyo, E. (2021). Psychological responses among Indonesian nurses in the outbreak of Covid-19 pandemic. Journal of Nursing Care, 4(2), 98-103. https://doi.org/10.24198/jnc.v4i2.31195

Newnham, H., Barker, A., Ritchie, E., Hitchcock, K., Gibbs, H., & Holton, S. (2017). Discharge communication practices and healthcare provider and patient preferences, satisfaction and comprehension: A systematic review. International Journal for Quality in Health Care, 29(6), 752-768. https://doi.org/10.1093/intqhc/mzx121

Noble, H., & Smith, J. (2015). Issues of validity and reliability in qualitative research. Evidence-Based Nursing, 18(2), 34-35. http://dx.doi.org/10.1136/eb-2015-102054

Okoniewska, B., Santana, M. J., Groshaus, H., Stajkovic, S., Cowles, J., Chakrovorty, D., & Ghali, W. A. (2015). Barriers to discharge in an acute care medical teaching unit: A qualitative analysis of health providers’ perceptions. Journal of Multidisciplinary Healthcare, 8, 83-89. https://doi.org/10.2147/JMDH.S72633

Plotnikoff, K. M., Krewulak, K. D., Hernández, L., Spence, K., Foster, N., Longmore, S., Straus, S. E., Niven, D. J., Parsons Leigh, J., & Stelfox, H. T. (2021). Patient discharge from intensive care: An updated scoping review to identify tools and practices to inform high-quality care. Critical Care, 25, 1-13. https://doi.org/10.1186/s13054-021-03857-2

Rahman, R. B. A. (2015). Comparison of telephone and in-person interviews for data collection in qualitative human research. Interdisciplinary Undergraduate Research Journal, 1(1), 10-13.

Reddick, B., & Holland, C. (2015). Reinforcing discharge education and planning. Nursing Management, 46(5), 10-14. https://doi.org/10.1097/01.NUMA.0000463887.70222.50

Rodakowski, J., Rocco, P. B., Ortiz, M., Folb, B., Schulz, R., Morton, S. C., Leathers, S. C., Hu, L., & James Iii, A. E. (2017). Caregiver integration during discharge planning for older adults to reduce resource use: A metaanalysis. Journal of the American Geriatrics Society, 65(8), 1748-1755. https://doi.org/10.1111/jgs.14873

Sakur, F., Ward, K., Khatri, N. N., & Lau, A. Y. S. (2022). Self-care behaviors and technology used during COVID-19: Systematic review. JMIR Human Factors, 9(2), e35173. https://doi.org/10.2196/35173

Sarango, D. E. R., Mesa-Cano, I. C., Ramírez-Coronel, A. A., & Brito, E. G. M. (2021). Nursing role in the covid-19 pandemic: Systematic review. Archivos Venezolanos de Farmacología y Terapéutica, 40(6), 575-580. https://doi.org/10.5281/zenodo.5557112

Sari, M., & Hairunisa, N. (2022). A review of the Monkeypox outbreak in Indonesia in 2022. Jurnal Kedokteran Diponegoro, 11(5), 268-274. https://doi.org/10.14710/dmj.v11i5.35895

Schmidt, B. J., & McArthur, E. C. (2018). Professional nursing values: A concept analysis. Nursing Forum, 53(1), 69-75. https://doi.org/10.1111/nuf.12211

Sepulveda-Pacsi, A. L. (2019). Emergency nurses’ perceived confidence in participating in the discharge process of congestive heart failure patients from the emergency department: A quantitative study. Hispanic Health Care International, 17(1), 30-35. https://doi.org/10.1177/1540415318818983

Shapiro, A., O’Toole, N., Tinling-Solages, D., McGarvey, T., Tretola, M., & Dunphey, P. (2020). Re-envisioning discharge planning and expanding post-acute care capacity during a pandemic. NEJM Catalyst Innovations in Care Delivery, 1(3), 1-7. https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0216

Sheikh, H., Brezar, A., Dzwonek, A., Yau, L., & Calder, L. (2018). Patient understanding of discharge instructions in the emergency department: Do different patients need different approaches? International Journal of Emergency Medicine, 11(5). https://doi.org/10.1186/s12245-018-0164-0

Smith, D. E. (2005). Institutional ethnography: A sociology for people. Oxford: Rowman Altamira.

Smith, D. E. (2006). Institutional ethnography as practice. Oxford: Rowman & Littlefield.

Stadick, J. L. (2020). The relationship between interprofessional education and health care professional's attitudes towards teamwork and interprofessional collaborative competencies. Journal of Interprofessional Education & Practice, 19, 100320. https://doi.org/10.1016/j.xjep.2020.100320

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357.

World Health Organization [WHO]. (2020). COVID-19: operational guidance for maintaining essential health services during an outbreak: Interim guidance. https://iris.who.int/handle/10665/331561

Wulandari, D. F., & Hariyati, R. T. (2019). Optimizing the implementation of discharge planning in x general hospital Jakarta. International Journal of Nursing and Health Services, 2(1), 70-81. https://doi.org/10.35654/ijnhs.v2i1.72

Yilmaz, F. T., Aldemir, K., & Yildiz, E. (2019). The discharge related education needs of inpatients being treated in the internal diseases clinic and affecting factors. International Journal of Caring Sciences, 12(3), 1658.

Yoon, S., Mo, J., Lim, Z. Y., Lu, S. Y., Low, S. G., Xu, B., Loo, Y. X., Koh, C. W., Kong, L. Y., & Towle, R. M. (2022). Impact of COVID-19 measures on discharge planning and continuity of integrated care in the community for older patients in Singapore. International Journal of Integrated Care, 22(2), 13. https://doi.org/10.5334%2Fijic.6416

Yunus, F., & Andarini, S. (2020). Letter from Indonesia. Respirology, 25(12), 1328-1329. https://doi.org/10.1111/resp.13953

Zechariah, S., Ansa, B. E., Johnson, S. W., Gates, A. M., & Leo, G. D. (2019). Interprofessional education and collaboration in healthcare: An exploratory study of the perspectives of medical students in the United States. Healthcare, 7(4), 117. https://doi.org/10.3390/healthcare7040117

Zurlo, A., & Zuliani, G. (2018). Management of care transition and hospital discharge. Aging Clinical and Experimental Research, 30, 263-270. https://doi.org/10.1007/s40520-017-0885-6

Readers are able to give us their valuable feedbacks here. The comments will be reviewed by the editors and then published here. Important Note: The "Comments" related to the Galley Proof PDF must NOT be submitted via this form. Authors should submit their comments on their galley proofs only via system