Using linked hospitalisation data to detect nursing sensitive outcomes: A retrospective cohort study

Background: Nursing sensitive outcomes are adverse patient health outcomes that have been shown to be associated with nursing care. Researchers have developed specific algorithms to identify nursing sensitive outcomes using administrative data sources, although contention still surrounds the ability...

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Main Authors: Schreuders, L., Bremner, A., Geelhoed, E., Finn, Judith
Format: Journal Article
Published: Elsevier Ltd 2013
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/23643
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author Schreuders, L.
Bremner, A.
Geelhoed, E.
Finn, Judith
author_facet Schreuders, L.
Bremner, A.
Geelhoed, E.
Finn, Judith
author_sort Schreuders, L.
building Curtin Institutional Repository
collection Online Access
description Background: Nursing sensitive outcomes are adverse patient health outcomes that have been shown to be associated with nursing care. Researchers have developed specific algorithms to identify nursing sensitive outcomes using administrative data sources, although contention still surrounds the ability to adjust for pre-existing conditions. Existing nursing sensitive outcome detection methods could be improved by using look-back periods that incorporate relevant health information from patient’s previous hospitalisations. Design and setting: Retrospective cohort study at three tertiary metropolitan hospitals in Perth, Western Australia.Objectives: The objective of this research was to explore the effect of using linked hospitalisation data on estimated incidence rates of eleven adverse nursing sensitive outcomes by retrospectively extending the timeframe during which relevant patient disease information may be identified. The research also explored whether patient demographics and/or the characteristics of their hospitalisations were associated with nursing sensitive outcomes.Results: During the 5 year study period there were 356,948 hospitalisation episodes involving 189,240 patients for a total of 2,493,654 inpatient days at the three tertiary metropolitan hospitals. There was a reduction in estimated rates for all nursing sensitive outcomes when a look-back period was applied to identify relevant health information from earlier hospitalisations within the preceding 2 years. Survival analysis demonstrates that the majority of relevant patient disease information is identified within approximately 2 years of the baseline nursing sensitive outcomes hospitalisation. Compared to patients without, patients with nursing sensitive outcomes were significantly more likely to be older (70 versus 58 years), female, have Charleson comorbidities, be direct transfers from another hospital, have a longer inpatient stay and spend time in intensive care units (p 0.001).Conclusions: The results of this research suggest that nursing sensitive outcome rates maybe over-estimated using current detection methods. Linked hospitalisation data enables the use of look-back periods to identify clinically relevant diagnosis codes recorded prior to the hospitalisation in which a nursing sensitive outcome is detected. Using linked hospitalisation data to incorporate look-back periods offers an opportunity to increase the accuracy of nursing sensitive outcome detection when using administrative data sources.
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spelling curtin-20.500.11937-236432017-09-13T14:00:17Z Using linked hospitalisation data to detect nursing sensitive outcomes: A retrospective cohort study Schreuders, L. Bremner, A. Geelhoed, E. Finn, Judith Health care Nursing Quality indicators Hospitalisation Nursing methodology research Medical record linkage Outcome Assessment (Health care) Care Background: Nursing sensitive outcomes are adverse patient health outcomes that have been shown to be associated with nursing care. Researchers have developed specific algorithms to identify nursing sensitive outcomes using administrative data sources, although contention still surrounds the ability to adjust for pre-existing conditions. Existing nursing sensitive outcome detection methods could be improved by using look-back periods that incorporate relevant health information from patient’s previous hospitalisations. Design and setting: Retrospective cohort study at three tertiary metropolitan hospitals in Perth, Western Australia.Objectives: The objective of this research was to explore the effect of using linked hospitalisation data on estimated incidence rates of eleven adverse nursing sensitive outcomes by retrospectively extending the timeframe during which relevant patient disease information may be identified. The research also explored whether patient demographics and/or the characteristics of their hospitalisations were associated with nursing sensitive outcomes.Results: During the 5 year study period there were 356,948 hospitalisation episodes involving 189,240 patients for a total of 2,493,654 inpatient days at the three tertiary metropolitan hospitals. There was a reduction in estimated rates for all nursing sensitive outcomes when a look-back period was applied to identify relevant health information from earlier hospitalisations within the preceding 2 years. Survival analysis demonstrates that the majority of relevant patient disease information is identified within approximately 2 years of the baseline nursing sensitive outcomes hospitalisation. Compared to patients without, patients with nursing sensitive outcomes were significantly more likely to be older (70 versus 58 years), female, have Charleson comorbidities, be direct transfers from another hospital, have a longer inpatient stay and spend time in intensive care units (p 0.001).Conclusions: The results of this research suggest that nursing sensitive outcome rates maybe over-estimated using current detection methods. Linked hospitalisation data enables the use of look-back periods to identify clinically relevant diagnosis codes recorded prior to the hospitalisation in which a nursing sensitive outcome is detected. Using linked hospitalisation data to incorporate look-back periods offers an opportunity to increase the accuracy of nursing sensitive outcome detection when using administrative data sources. 2013 Journal Article http://hdl.handle.net/20.500.11937/23643 10.1016/j.ijnurstu.2013.06.006 Elsevier Ltd fulltext
spellingShingle Health care
Nursing
Quality indicators
Hospitalisation
Nursing methodology research
Medical record linkage
Outcome Assessment (Health care)
Care
Schreuders, L.
Bremner, A.
Geelhoed, E.
Finn, Judith
Using linked hospitalisation data to detect nursing sensitive outcomes: A retrospective cohort study
title Using linked hospitalisation data to detect nursing sensitive outcomes: A retrospective cohort study
title_full Using linked hospitalisation data to detect nursing sensitive outcomes: A retrospective cohort study
title_fullStr Using linked hospitalisation data to detect nursing sensitive outcomes: A retrospective cohort study
title_full_unstemmed Using linked hospitalisation data to detect nursing sensitive outcomes: A retrospective cohort study
title_short Using linked hospitalisation data to detect nursing sensitive outcomes: A retrospective cohort study
title_sort using linked hospitalisation data to detect nursing sensitive outcomes: a retrospective cohort study
topic Health care
Nursing
Quality indicators
Hospitalisation
Nursing methodology research
Medical record linkage
Outcome Assessment (Health care)
Care
url http://hdl.handle.net/20.500.11937/23643