Resource Factors Associated With Avoidable Transfers in Nursing Homes.
Matthew S Farmer, Alisha H Johnson, Kimberly R Powell
PMID 41429189WHAT IT FOUND
Nursing home transfers were more often judged avoidable when staff were uncomfortable with the resident's change in condition or an advanced practice registered nurse or RN was unavailable.
Onsite clinician and equipment gaps were more often linked to transfers judged unavoidable.
Key findings
01Lack of staff comfort or experience and unavailable APRN or RN consultation were associated with higher odds of an avoidable transfer.
02Limited onsite clinician or equipment resources were associated with higher odds of an unavoidable transfer.
03Delayed diagnostics showed no clear association with avoidable transfer.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a cross-sectional analysis of existing transfer-event surveys, so it shows association, not proof that resource gaps caused avoidable transfers. The same advanced practice registered nurses completed the resource surveys and judged whether transfers were avoidable, so their perceptions could influence both the reported gaps and the outcome. The analysis focused on resource items from INTERACT surveys; resident preferences, family insistence, provider preferences, and other variables were not fully included in the primary factor model. Only 16 Missouri nursing homes in one quality initiative were studied, so results may not apply to other settings. Short-stay residents were excluded, so findings do not address transfers soon after admission or during rehabilitation. The factor labels are simplified descriptions of survey items and may mix different resource problems.
Declared interests
The article is listed as supported by NIH extramural and non-U.S. Government research support; no author conflict-of-interest statement is included.
The easy way to misread this
Do not conclude that improving staffing, comfort, or APRN/RN access will reduce avoidable transfers. This study observed associations in existing transfer records, and the nurses who reported the resource gaps also decided whether transfers were avoidable.