Effectiveness of nurse-led discharge service on adult surgical inpatients: A meta-analysis of randomized controlled trials.
Huina Mao, Yarui Xie, Ying Shen and 2 others
PMID 35661429WHAT IT FOUND
Nurse-led discharge services did not shorten hospital stays, but they reduced readmissions and emergency visits and improved quality of life in adult surgical patients.
Key findings
01Nurse-led discharge services reduced readmission (risk ratio 0.41, 95% CI 0.32 to 0.53, p < .001) and emergency visits (risk ratio 0.44, 95% CI 0.29 to 0.68, p < .001) compared with routine care.
02Length of stay did not show a significant difference (pooled difference -0.49, 95% CI -1.01 to 0.02, p = .06).
03Quality of life scores were higher in the intervention group (SF-36 difference 7.40 points on the 0 to 100 scale, 95% CI 5.57 to 9.22, p < .001).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The trials used different nurse-led discharge bundles, and many did not report the start time, team structure or exact follow-up details. Several risk-of-bias items were unclear, including allocation concealment, blinding of participants or personnel, and blinding of outcome assessors. Follow-up loss was found in all included studies, and only some used intention-to-treat analysis. Quality of life outcomes were pooled from only two trials each, and the SF-12 analysis had 97% heterogeneity. The review included only English and Chinese published studies, so relevant trials in other languages or unpublished work may be missing. Because the intervention was a bundle, the contribution of any single component cannot be separated.
The easy way to misread this
Do not conclude that nurse-led discharge shortens hospital stay. Length of stay did not show a significant difference (pooled difference -0.49, 95% CI -1.01 to 0.02, p = .06). Also, the intervention was a bundle that could include perioperative nursing, health education, postoperative rehabilitation and follow-up, so do not assume any one component caused the benefits.