Key result
Lower average registered nurse-assessed Readiness for Hospital Discharge Survey (RN-RHDS) scores were associated with requiring hospital-based acute care within 60 days after discharge.
Why the study?
The relationship between unplanned postdischarge acute care utilization and nurse and patient perceptions of available instrumental support was evaluated.
Do patient and nurse perceptions of available instrumental support post-discharge predict unplanned acute care utilization within 60 days?
Observational (n=13,361)
Yes
Do patient and nurse perceptions of available instrumental support post-discharge predict unplanned acute care utilization within 60 days?
Lower nurse-assessed readiness for hospital discharge scores regarding instrumental support are associated with higher rates of unplanned acute care utilization within 60 days.
Lower RN-perceived instrumental support associated with 60-day unplanned acute care use; leaves open whether routine assessment improves discharge planning.
PURPOSE OF STUDY: Evaluate the relationship between unplanned acute care utilization after discharge from an index hospital admission and registered nurse and patient perceptions of available instrumental support the patient would have after discharge. PRIMARY PRACTICE SETTING: Three hospitals in a large regional hospital system in the southeastern United States. METHODOLOGY AND SAMPLE: Retrospective, secondary quantitative analysis of 13,361 patient records (mean age 58.4 years; 51% female) from index hospitalizations evaluating patient and nurse responses to 2 questions that specifically address instrumental support on both the patient and nurse versions of the Readiness for Hospital Discharge Survey (RHDS) and subsequent unexpected care received (emergency department [ED] visit, observation stay, hospital readmission) in the acute care setting within 60 days of discharge. Logistic regression was used to evaluate the relationship between RHDS scores and unplanned care received. RESULTS: Patients who required hospital-based acute care within 60 days after discharge had lower average RN-RHDS scores than those who did not require hospital-based acute care. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Including a nursing assessment of potential postdischarge expected instrumental support may be helpful in identifying patients who are at a higher risk of experiencing postdischarge acute care utilization. Monitoring ED visits and observation stays in addition to readmissions will facilitate capturing significantly more points of care received after discharge and provide additional information regarding postdischarge care utilization.
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Schultz et al. (2022) conducted an observational in Hospital discharge (n=13,361). Registered nurse and patient perceptions of available instrumental support (RHDS scores) vs. Higher vs lower RHDS scores was evaluated on Unexpected care received (emergency department visit, observation stay, hospital readmission) in the acute care setting within 60 days of discharge. Lower average registered nurse-assessed Readiness for Hospital Discharge Survey (RN-RHDS) scores were associated with requiring hospital-based acute care within 60 days after discharge.
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