Nurse staffing, work environment linked to readmissions after total joints

Many efforts to reduce readmissions after total joint procedures have focused on transitional and postacute care, but few acknowledge the importance of the nursing care delivered during the patient’s hospitalization.

This study from the University of Pennsylvania School of Nursing, Philadelphia, examines the effect of nurse staffing and the work environment on 10- and 30-day unplanned readmissions for Medicare patients following total hip and knee replacements. The analysis included data on more than 112,000 patients in nearly 500 hospitals.

Adjusting for patient and hospital characteristics, the researchers found that each additional patient in a nurse’s workload was associated with an 8% higher odds of 30-day readmission and a 12% higher odds of 10-day readmission.

Patients who had surgery in hospitals where nurses reported having supportive environments, including strong collegial relationships with physicians and autonomy in clinical practice, were 12% less likely to be readmitted within 30 days.

Attention to nurse working conditions may be central to improving readmission in this postoperative total joint Medicare population, the researchers note.

−Lasater K B, McHugh M D. Nurse staffing and the work environment linked to readmissions among older adults following elective total hip and knee replacement.

Int J Qual Health Care.2016;28(2):253-258.

http://intqhc.oxfordjournals.org/content/28/2/253