Effectiveness of nurse‐led discharge service on adult surgical inpatients: A meta‐analysis of randomized controlled trials

Q: What are the key findings of this study?

Nurse-led discharge service significantly reduced the risk of hospital readmission (RR 0.41) and emergency visits (RR 0.44) compared to routine care in adult surgical inpatients.

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Adult surgical inpatients (n=1649). Intervention: Nurse-led discharge service vs. Routine hospital care. Primary outcome: Hospital readmission (RR 0.41, 95% CI 0.32-0.53, p=<0.001).

Q: What question did this study set out to answer?

To determine the effectiveness of nurse-led discharge services on post-discharge outcomes in adult surgical inpatients.

Huina Mao; Yarui Xie; Ying Shen; Mei Wang; Yingxia Luo

doi:10.1002/nop2.1268

June 6, 2022Nursing OpenOpen Access

Effectiveness of nurse‐led discharge service on adult surgical inpatients: A meta‐analysis of randomized controlled trials

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Key result

Nurse-led discharge cuts readmissions ~59% and reduces emergency visits versus routine care in surgical inpatients.

RR 0.41
95% CI 0.32-0.53
P<0.001
n=1,649

Figures

Why the study?

The study was conducted to determine the effectiveness of a nurse-led discharge service for adult surgical inpatients.

Does a nurse-led discharge service reduce readmissions and improve outcomes in adult surgical inpatients?

Key Points

To determine the effectiveness of nurse-led discharge services on post-discharge outcomes in adult surgical inpatients.
Searched 10 international and Chinese databases (including PubMed, Cochrane Library, Embase, and CNKI) for randomized controlled trials using PRISMA guidelines.
Conducted independent data extraction, risk-of-bias evaluation, and meta-analyses using Review Manager 5.4.1 across 12 trials encompassing 1,649 participants.
Nurse-led discharge interventions significantly decreased post-discharge readmission rates and emergency department visits compared with control care.
Intervention recipients achieved higher scores in activities of daily living and overall quality of life.
Length of hospital stay showed no statistically significant difference between the intervention and control groups.

Study Design

Type

Meta-Analysis (n=1,649)

Structured PICO

Does a nurse-led discharge service reduce readmissions and improve outcomes in adult surgical inpatients?

P

Population

1,649 adult surgical inpatients pooled from 12 randomized controlled trials

I

Intervention

Nurse-led discharge service

C

Comparator

Control group (standard care)

O

Outcome

Readmission rate

Main Result

Effect estimate: RR 0.41 (95% CI 0.32-0.53)

p-value: p=<0.001

Nurse-led discharge services effectively reduce readmissions and emergency visits while improving functional outcomes and quality of life in adult surgical inpatients.

Limitations

Only two studies were included in the quality of life outcomes (SF-12 and SF-36), making those results potentially unreliable.
Literature search excluded unpublished grey literature and non-Chinese or English literature.
Original data form of some studies was not specific, leading to missing outcomes.
Interventions heterogeneity could not be avoided among the included trials.

Implication

Supports nurse-led discharge adoption in surgical care; confirms readmission reductions across trials.

Abstract

AIM: To determine the effectiveness of nurse-led discharge service for adult surgical inpatients. DESIGN: The report of this review was conducted by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement checklist. METHODS: The PubMed, Web of Science, ScienceDirect, Cochrane Library (CENTRAL), MEDLINE and Embase as well as four Chinese databases including CNKI, Wanfang database, VIP database and CBM were searched for randomized controlled trials. Two reviewers independently extracted data and assessed risk of bias. And meta-analyses were conducted for the eligible studies by Review manager 5.4.1. RESULTS: A total of 1,649 participants were enrolled in 12 randomized controlled trials. The result of readmission rate and emergency visit of intervention group were lower than those of the control group; activities of daily living and quality of life in the intervention group were higher than that of the control group. There was no statistical difference in the length of stay between the two groups.

Discussion

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Cite This Study

Mao et al. (2022) conducted a meta-analysis in Adult surgical inpatients (n=1,649). Nurse-led discharge service vs. Routine hospital care was evaluated on Hospital readmission (RR 0.41, 95% CI 0.32-0.53, p=<0.001). Nurse-led discharge service significantly reduced the risk of hospital readmission (RR 0.41) and emergency visits (RR 0.44) compared to routine care in adult surgical inpatients.

synapsesocial.com/papers/6a0ef5d8aa1655e5fb231088 https://doi.org/10.1002/nop2.1268

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Effectiveness of nurse‐led discharge service on adult surgical inpatients: A meta‐analysis of randomized controlled trials

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Effectiveness of nurse‐led discharge service on adult surgical inpatients: A meta‐analysis of randomized controlled trials

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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