Nurse and patient perceptions of discharge readiness in relation to postdischarge utilization. Med Care 2010 May;48(5):482-6
Date
04/16/2010Pubmed ID
20393364DOI
10.1097/MLR.0b013e3181d5feaeScopus ID
2-s2.0-77951623339 (requires institutional sign-in at Scopus site) 90 CitationsAbstract
BACKGROUND: Prevention of hospital readmission and emergency department (ED) utilization will be a crucial strategy in reducing health care costs. There has been limited research on nurse assessment and patient perceptions of discharge readiness in relation to postdischarge outcomes.
OBJECTIVES: To investigate the association of nurse and patient assessments of discharge readiness with postdischarge readmissions and ED visits.
RESEARCH DESIGN: Hierarchical regression analysis of readmission or ED utilization using independent nurse and patient assessments of discharge readiness and patient characteristics as explanatory variables, with hospital and unit fixed effects.
SUBJECTS: A total of 162 adult medical-surgical patients and their discharging nurses from 13 medical-surgical units of 4 Midwestern hospitals.
MEASURES: Readiness for Hospital Discharge Scale completed independently by patients and their discharging nurses within 4 hours before hospital discharge; Postdischarge utilization (unplanned readmission or ED visit within 30 days postdischarge).
RESULTS: Correlations between nurse assessment and patient perceptions of discharge readiness were low (r = 0.15-0.32). Nurses rated patient readiness higher than patients themselves. Controlling for patient characteristics, nurse readiness for hospital discharge scale score (odds ratio = 0.57, P = 0.05) but not patient readiness for hospital discharge scale score was associated with postdischarge utilization.
CONCLUSIONS: Nurse assessment was more strongly associated with postdischarge utilization than patient self-assessment. Formalizing nurse assessment of discharge readiness could facilitate identification of patients at risk for readmission or ED utilization before discharge when anticipatory interventions could prevent avoidable postdischarge utilization.
Author List
Weiss M, Yakusheva O, Bobay KAuthor
Kathleen Bobay PhD Associate Professor in the Nursing department at Marquette UniversityMESH terms used to index this publication - Major topics in bold
AdultAge Factors
Aged
Aged, 80 and over
Emergency Service, Hospital
Female
Humans
Length of Stay
Male
Middle Aged
Nurses
Patient Discharge
Patient Readmission
Patients
Perception
Severity of Illness Index
Sex Factors
Socioeconomic Factors
Young Adult
