Patients rated by nurses as less ready for discharge (RN-RHDS score <7) were 6.4 to 9.3 times more likely to return to the hospital within 30 days.
Observational
Yes
Does the RN-RHDS score predict 30-day readmissions and emergency department visits in medical-surgical patients?
The RN-RHDS is a reliable tool that can predict 30-day unplanned hospital returns, allowing nurses to implement interventions prior to discharge.
Effect estimate: 6.4-9.3 times more likely
BACKGROUND: Statistical models for predicting readmissions have been published for high-risk patient populations but typically focus on patient characteristics; nurse judgment is rarely considered in a formalized way to supplement prediction models. OBJECTIVES: The purpose of this study was to determine psychometric properties of long and short forms of the Registered Nurse Readiness for Hospital Discharge Scale (RN-RHDS), including reliability, factor structure, and predictive validity. METHODS: Data were aggregated from two studies conducted at four hospitals in the Midwestern United States. The RN-RHDS was completed within 4 hours before hospital discharge by the discharging nurse. Data on readmissions and emergency department visits within 30 days were extracted from electronic medical records. RESULTS: The RN-RHDS, both long and short forms, demonstrate acceptable reliability (Cronbach's alphas of .90 and .73, respectively). Confirmatory factor analysis demonstrated less than adequate fit with the same four-factor structure observed in the patient version. Exploratory factor analysis identified three factors, explaining 60.2% of the variance. When nurses rate patients as less ready to go home (<7 out of 10), patients are 6.4-9.3 times more likely to return to the hospital within 30 days, in adjusted models. DISCUSSION: The RN-RHDS, long and short forms, can be used to identify medical-surgical patients at risk for potential unplanned return to hospital within 30 days, allowing nurses to use their clinical judgment to implement interventions prior to discharge. Use of the RN-RHDS could enhance current readmission risk prediction models.
Bobay et al. (Tue,) conducted a observational in Medical-surgical patients. Low readiness for discharge (RN-RHDS score <7 out of 10) vs. Higher readiness for discharge (RN-RHDS score ≥7) was evaluated on Return to the hospital within 30 days (readmissions and emergency department visits) (6.4-9.3 times more likely). Patients rated by nurses as less ready for discharge (RN-RHDS score <7) were 6.4 to 9.3 times more likely to return to the hospital within 30 days.