Worse Nursing-Sensitive Indicators in Black-Serving Hospitals.
Eileen T Lake, Celsea C Tibbitt, John F Rizzo and 4 others
PMID 40088420WHAT IT FOUND
Hospitals serving the highest proportion of Black patients had higher rates of pressure ulcers, postoperative sepsis, and blood clots after surgery than hospitals serving the lowest proportion; death among surgical inpatients with serious treatable conditions did not differ.
Key findings
01High Black-serving hospitals had a 6% higher sepsis rate, a 7% higher perioperative PE/DVT rate, and an 18% higher pressure ulcer rate than low Black-serving hospitals.
02Failure to rescue averaged 143.58 per 1,000 surgical discharges with serious treatable conditions and varied without a clear pattern by hospital Black-serving category.
03After accounting for hospital case mix, the higher rates in high Black-serving hospitals remained for pressure ulcers, PE/DVT, and sepsis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis was at hospital level, not patient level, so it cannot show risk for an individual patient or prove why the rates differ. Hospitals with low patient volume and low numbers for these rates were excluded, so small hospitals are not represented. The indicator rates were based on older adult patients only, not all hospitalized patients. Failure to rescue was reported in fewer than half of eligible hospitals because it required a minimum number of complications. The regression adjusted for hospital case mix but not for other factors that could explain the differences.
Declared interests
The authors reported no conflicts of interest. The article is listed as supported by an NIH extramural grant.
The easy way to misread this
Do not conclude that Black-serving hospitals have worse nursing care or that nursing caused these complications. The study compares hospital-level indicator rates, not patient-level nursing actions, and cannot show why the rates differ.