More with document work, less with patient care: An institutional
ethnography of discharge planning practices for diabetic patients

Dublin Core

Title

More with document work, less with patient care: An institutional
ethnography of discharge planning practices for diabetic patients

Subject

accreditation; diabetes mellitus; documentation; hospital
discharge; nurses

Description

Background: Diabetic patients required comprehensive discharge planning.
However, this is a complex and challenging process. Nurses play significant
roles and experience tensions in operating the everyday discharge planning
practices.
Purpose: to explore how nurses’ everyday activities in providing DP for
diabetic patients were regulated by the ruling relations operating in the
hospital as an institutional context.
Methods: This institutional ethnography study applied phone-call interviews
with 18 participants, participant observation, and document review to collect
the data. Data analysis was concurrently conducted with the data collection
processes following the institutional ethnography analytical approach.
Trustworthiness was established.
Results: The everyday discharge planning practices for diabetic patients
follow the flow of patient care. Nurses perceived these practices to be
problematic as the initial assessment form did not guide the discharge
education, which was informal and unstructured, and documentation was
burdensome. The hospital accreditation, nurse ward manager, and the
registered nurse were identified as the ruling relations that regulate those
practices through the hospitals’ standards and forms, monitoring, and
completeness principle.
Conclusion: The hospital’s forms, monitoring, and completeness principles
are activated as the ruling relation that regulates the discharge planning
practices for diabetic patients for satisfying good hospital service quality
through standards and forms, monitoring, and completeness principles. This
situation drives nurses to work more closely with the documents. Further
study is crucial to identify a strategy to effectively bridge discharge planning
practices and documentations works.

Creator

Titis Kurniawan1,5 , Kittikorn Nilmanat2* , Umaporn Boonyasopun3 ,
Amelia Ganefianty4

Source

http://jkp.fkep.unpad.ac.id/index.
php/jkp

Date

August 14, 2024

Contributor

PERI IRAWAN

Format

PDF

Language

ENGLISH

Type

TEXT

Files

Citation

Titis Kurniawan1,5 , Kittikorn Nilmanat2* , Umaporn Boonyasopun3 , Amelia Ganefianty4, “More with document work, less with patient care: An institutional
ethnography of discharge planning practices for diabetic patients,” Repository Horizon University Indonesia, accessed February 11, 2026, https://repository.horizon.ac.id/items/show/10718.