Better nurse work environments associated with fewer readmissions and shorter length of stay among adults with ischemic stroke: A cross-sectional analysis of United States hospitals.
ischemic stroke
length of stay
nurse work environment
readmission
Journal
Research in nursing & health
ISSN: 1098-240X
Titre abrégé: Res Nurs Health
Pays: United States
ID NLM: 7806136
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
15
01
2021
received:
20
10
2020
accepted:
13
02
2021
pubmed:
3
3
2021
medline:
27
8
2021
entrez:
2
3
2021
Statut:
ppublish
Résumé
Stroke is among the most common reasons for disability and death. Avoiding readmissions and long lengths of stay among ischemic stroke patients has benefits for patients and health care systems alike. Although reduced readmission rates among a variety of medical patients have been associated with better nurse work environments, it is unknown how the work environment might influence readmissions and length of stay for ischemic stroke patients. Using linked data sources, we conducted a cross-sectional analysis of 543 hospitals to evaluate the association between the nurse work environment and readmissions and length of stay for 175,467 hospitalized adult ischemic stroke patients. We utilized logistic regression models for readmission to estimate odds ratios (OR) and zero-truncated negative binomial models for length of stay to estimate the incident-rate ratio (IRR). Final models accounted for hospital and patient characteristics. Seven and 30-day readmission rates were 3.9% and 10.1% respectively and the average length of stay was 4.9 days. In hospitals with better nurse work environments ischemic stroke patients experienced lower odds of 7- and 30-day readmission (7-day OR, 0.96; 95% confidence interval [CI]: 0.93-0.99 and 30-day OR, 0.97; 95% CI: 0.94-0.99) and lower length of stay (IRR, 0.97; 95% CI: 0.95-0.99). The work environment is a modifiable feature of hospitals that should be considered when providing comprehensive stroke care and improving post-stroke outcomes.
Identifiants
pubmed: 33650707
doi: 10.1002/nur.22121
pmc: PMC8258897
mid: NIHMS1710354
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
525-533Subventions
Organisme : NINR NIH HHS
ID : R01 NR014855
Pays : United States
Organisme : NIMHD NIH HHS
ID : R01 MD011518
Pays : United States
Organisme : NINR NIH HHS
ID : R01 NR016002
Pays : United States
Organisme : NINR NIH HHS
ID : T32 NR007104
Pays : United States
Informations de copyright
© 2021 Wiley Periodicals LLC.
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