Nurse Work Environment and Hospital Readmission Disparities Between Patients With and Without Limited English Proficiency.
Kathy Sliwinski, Matthew D McHugh, Allison P Squires and 2 others
PMID 40126025WHAT IT FOUND
Hospitalized patients who preferred a language other than English had higher seven-day readmission rates.
Favorable nurse work environments were linked to lower readmission for these patients compared with others, but the study cannot prove better staffing caused it.
Key findings
01Patients with limited English proficiency had higher seven-day readmission rates than patients without limited English proficiency (4.5% vs 3.9%).
02After adjustment for patient and hospital characteristics, limited English proficiency was associated with higher odds of seven-day readmission (OR 1.33).
03The interaction between limited English proficiency and favorable nurse work environment was significant (OR 0.83), and patients with limited English proficiency had lower odds in favorable environments.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design cannot determine whether favorable nurse work environments caused lower readmission odds. The data are from 2016 and only New Jersey, so they may not apply to other states or later years. The sample excluded patients who died, went to hospice, left against medical advice, had psychiatric, drug or alcohol, labor or delivery admissions, stayed more than 60 days, or were discharged after December 26, 2016. Most differences between patients with and without limited English proficiency had small effect sizes, except race and ethnicity.
Declared interests
The authors declared no conflicts of interest. The research was supported by the National Institute of Nursing Research and the Agency for Healthcare Research and Quality.
The easy way to misread this
Do not read the favorable work environment finding as proof that better staffing caused lower readmissions for all patients. The study is cross-sectional, the direct work environment effect was not significant, and no work environment intervention was tested.