Unmet Nursing Care Linked to Rehospitalizations Among Older Black AMI Patients

A Cross-Sectional Study of US Hospitals

Dados Bibliográficos

ID9102349
AutoresJ Margo Brooks-Carthon (American Academy of Neurology), Karen B Lasater (0000-0002-5834-1954, American Academy of Neurology), Jessica Rearden (0000-0001-8665-9401, American Academy of Neurology), Sara Holland, Sara B Holland (0000-0002-5513-1994, American Academy of Neurology), Douglas M Sloane (0000-0003-2541-9783, American Academy of Neurology)
Ano2016
Volume54
Fascículo5
Páginas457-465
Data de publicação2016-05-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000519
PMID27075902
OpenAlexW2339071931
IdiomaEN
Citações recebidas2
Referências citadas46

BACKGROUND: Recent studies suggest that nurses may be unable to complete all aspects of necessary care due to a lack of time. Research is needed to determine whether unmet nursing care contributes to disparities in readmissions for vulnerable populations. OBJECTIVES: To examine differences in the relationship between nursing care left undone and acute myocardial infarction readmissions among older black patients compared with older white patients. RESEARCH DESIGN: Cross-sectional analysis of multiple datasets, including: 2006 to 2007 administrative discharge data, a survey of registered nurses, and the American Hospital Association Annual Survey. Risk-adjusted logistic regression models were used to estimate the association between care left undone and 30-day readmission. Interactions were used to examine the moderating effect of care left undone on readmission by race. RESULTS: The sample included 69,065 patients in 253 hospitals in California, New Jersey, and Pennsylvania. Older black patients were 18% more likely to experience a readmission after adjusting for patient and hospital characteristics and more likely to be in hospitals where nursing care was often left undone. Black patients were more likely to be readmitted when nurses were unable to talk/comfort patients [odds ratio (OR), 1.09; 95% confidence interval (CI), 1.01-1.19], complete documentation (OR, 1.16; 95% CI, 1.01-1.32), or administer medications in a timely manner (OR, 1.26; 95% CI, 1.09-1.46). CONCLUSIONS: Unmet nursing care is associated with readmissions for older black patients following acute myocardial infarction. Investment in nursing resources to improve the delivery of nursing care may decrease disparities in readmission

Acute care · Confidence interval · Cross-sectional study · Family medicine · Health care · Logistic regression · MEDLINE · Myocardial infarction · Nursing care · Odds · Odds ratio · Emergency and Acute Care Studies · Emergency Medicine · Heart Failure Treatment and Management · Internal Medicine · Medicine · Nursing · Sepsis Diagnosis and Treatment