RNCase-ControlNursing open2024

Nursing diagnoses and hospital readmission of patients with respiratory diseases: Findings from a case-control study.

Paloma Suárez-González, Ane Suárez-Elosegui, Lucía Arias-Fernández and 3 others

PMID 38783599

WHAT IT FOUND

Discharge nursing diagnoses of knowledge deficit, activity intolerance due to fatigue, or impaired skin integrity and risk of ulcer infection were associated with higher readmission risk within 30 days among 3781 respiratory patients.

Key findings

01Of 3781 patients admitted for respiratory disease, 499 (13.1%) were readmitted within 30 days of discharge.

02Knowledge deficit (OR: 1.61), impaired skin integrity and risk of ulcer infection (OR: 1.45), and activity intolerance due to fatigue (OR: 1.56) were associated with increased 30-day readmission risk.

03Readmitted patients were more often men, older, admitted on a scheduled basis, admitted to internal medicine, had longer hospital stays, and had more comorbidities.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This was a single-hospital case-control study using existing electronic records, so the associations may not apply to other settings or patient groups. Cases and controls were not matched, and the analysis could not rule out residual confounding from factors not recorded. The study relied on electronic nursing records, and the authors say it is unknown whether nursing diagnoses were assigned with enough rigour. Nurse documentation workload may have affected record quality. Important social and follow-up information, including community continuity of care, was not available. The study found associations, not proof that treating these nursing diagnoses prevents readmission.

Declared interests

The study was funded by a grant from the Official College of Nursing of Asturias. The funder had no role in study design, data analysis, interpretation, writing, or submission. The authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that these nursing diagnoses cause readmission or that treating them will prevent readmission. This was an observational case-control study, and the associations may reflect patient complexity, comorbidity, or documentation differences rather than a proven effect.

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