Table 4.
Effect of a 10% increase in missed nursing care on odds of 30-day readmission
| Nursing care activities |
Model 1 Unadjusted OR (95% CI) |
Model 2 Patient characteristics OR (95% CI) |
Model 3 Hospital characteristics OR (95% CI) |
Model 4 Patient and hospital characteristics OR (95% CI) |
Model 5 Patient, hospital characteristics and work environment OR (95% CI) |
|---|---|---|---|---|---|
| Care coordination | 1.06*** | 1.05** | 1.05** | 1.03* | 1.02 |
| (1.03 to 1.09) | (1.02 to 1.08) | (1.02 to 1.08) | (1.00 to 1.06) | (0.99 to 1.05) | |
| Documentation | 1.04*** | 1.03** | 1.02 | 1.01 | 1.00 |
| (1.02 to 1.06) | (1.01 to 1.05) | (1.00 to 1.04) | (0.99 to 1.03) | (1.00 to 1.02) | |
| Timely medications | 1.03 | 1.02 | 1.02 | 1.01 | 1.01 |
| (1.00 to 1.06) | (0.98 to 1.05) | (0.99 to 1.05) | (0.98 to 1.04) | (0.97 to 1.04) | |
| Pain management | 1.01 | 0.99 | 0.99 | 0.97 | 0.95 |
| (0.96 to 1.07) | (0.94 to 1.05) | (0.94 to 1.05) | (0.91 to 1.02) | (0.90 to 1.01) | |
| Care planning | 1.03*** | 1.03*** | 1.02** | 1.02* | 1.01 |
| (1.02 to 1.05) | (1.02 to 1.04) | (1.01 to 1.03) | (1.00 to 1.03) | (1.00 to 1.03) | |
| Discharge preparation | 1.03* | 1.03 | 1.02 | 1.02 | 1.01 |
| (1.00 to 1.06) | (0.99 to 1.06) | (0.99 to 1.05) | (0.99 to 1.05) | (0.98 to 1.04) | |
| Surveillance | 1.03** | 1.03** | 1.02 | 1.01 | 1.00 |
| (1.01 to 1.05) | (1.01 to 1.05) | (1.00 to 1.04) | (0.99 to 1.03) | (0.98 to 1.02) | |
| Talking/comforting | 1.04*** | 1.03** | 1.03*** | 1.02 | 1.01 |
| (1.02 to 1.05) | (1.01 to 1.05) | (1.01 to 1.05) | (1.00 to 1.04) | (1.00 to 1.03) | |
| Teaching/counselling | 1.04*** | 1.04*** | 1.03*** | 1.02* | 1.01 |
| (1.03 to 1.06) | (1.02 to 1.06) | (1.02 to 1.05) | (1.00 to 1.04) | (0.99 to 1.03) | |
| Treatments/procedures | 1.12*** | 1.09** | 1.10*** | 1.08** | 1.07* |
| (1.06 to 1.18) | (1.04 to 1.15) | (1.04 to 1.16) | (1.02 to 1.14) | (1.01 to 1.13) |
Author’s analysis
Model 2 adjusts for patient-level characteristics: race, age, sex, comorbidities, length of stay, socioeconomic status and discharge disposition. Model 3 adjusts for hospital-level characteristics: geographical location, profit type, technology status, teaching status, bed size, volume, cost-to-charge ratio and nurse staffing. Model 4 adjusts for patient and hospital characteristics. Model 5 adjusts for patient, hospital characteristics and the nurse work environment. All models used robust procedures to account for clustering of patients in hospitals.
*
p<0.05,
**
p<0.01,
***
p<0.001.