{"title":"The effect of fragmented cancer care and change in nurse staffing grade on cancer patient mortality.","authors":"Kyu-Tae Han, Seungju Kim","doi":"10.1111/wvn.12676","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Continuity of patient care ensures timely and appropriate care and is associated with better patient outcomes among cancer patients. However, the impact of nurse staffing grade changes on patient outcomes remains unknown.</p><p><strong>Aims: </strong>This retrospective cohort study aimed to evaluate the effect of fragmented care and changes in nurse staffing grade on the survival of colorectal cancer patients who underwent surgery.</p><p><strong>Methods: </strong>This study included 2228 newly diagnosed colorectal cancer patients. Fragmented care was defined as the receipt of treatment in multiple hospitals and was divided into three categories based on changes in nurse staffing grade. Five-year survival rates were used to evaluate the effect of fragmented care and nurse staffing grade on outcomes of cancer patients. Survival analysis was performed by adjusting for covariates using the Cox proportional hazards model for 5-year mortality.</p><p><strong>Results: </strong>Approximately 18.5% of patients died within 5 years; the mortality rate during cancer treatment was higher in patients who received fragmented care, especially in those transferred to hospitals with fewer nurses. Patients who received fragmented care had shorter survival times, and those transferred to hospitals with fewer nurses had higher risks of 5-year mortality (hazard ratio: 1.625; 95% CI: [1.095, 2.412]). Transfers to hospitals with fewer nurses were associated with increased mortality rates in low-income patients, hospitals located in metropolitan and rural areas, and high-severity groups.</p><p><strong>Linking evidence to action: </strong>Receipt of fragmented care and change in nurse staffing grade due to patients' transfer to different hospitals were associated with increased mortality rates in cancer patients, thus underlining the importance of ensuring continuity and quality of care. Patients from rural areas, from low-income families, and with high disease severity may have better outcomes if they receive treatment in well-staffed hospitals.</p>","PeriodicalId":49355,"journal":{"name":"Worldviews on Evidence-Based Nursing","volume":" ","pages":"610-620"},"PeriodicalIF":3.4000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Worldviews on Evidence-Based Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/wvn.12676","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/10 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Continuity of patient care ensures timely and appropriate care and is associated with better patient outcomes among cancer patients. However, the impact of nurse staffing grade changes on patient outcomes remains unknown.
Aims: This retrospective cohort study aimed to evaluate the effect of fragmented care and changes in nurse staffing grade on the survival of colorectal cancer patients who underwent surgery.
Methods: This study included 2228 newly diagnosed colorectal cancer patients. Fragmented care was defined as the receipt of treatment in multiple hospitals and was divided into three categories based on changes in nurse staffing grade. Five-year survival rates were used to evaluate the effect of fragmented care and nurse staffing grade on outcomes of cancer patients. Survival analysis was performed by adjusting for covariates using the Cox proportional hazards model for 5-year mortality.
Results: Approximately 18.5% of patients died within 5 years; the mortality rate during cancer treatment was higher in patients who received fragmented care, especially in those transferred to hospitals with fewer nurses. Patients who received fragmented care had shorter survival times, and those transferred to hospitals with fewer nurses had higher risks of 5-year mortality (hazard ratio: 1.625; 95% CI: [1.095, 2.412]). Transfers to hospitals with fewer nurses were associated with increased mortality rates in low-income patients, hospitals located in metropolitan and rural areas, and high-severity groups.
Linking evidence to action: Receipt of fragmented care and change in nurse staffing grade due to patients' transfer to different hospitals were associated with increased mortality rates in cancer patients, thus underlining the importance of ensuring continuity and quality of care. Patients from rural areas, from low-income families, and with high disease severity may have better outcomes if they receive treatment in well-staffed hospitals.
期刊介绍：
The leading nursing society that has brought you the Journal of Nursing Scholarship is pleased to bring you Worldviews on Evidence-Based Nursing. Now publishing 6 issues per year, this peer-reviewed journal and top information resource from The Honor Society of Nursing, Sigma Theta Tau International, uniquely bridges knowledge and application, taking a global approach in its presentation of research, policy and practice, education and management, and its link to action in real world settings.
Worldviews on Evidence-Based Nursing is written especially for:
Clinicians
Researchers
Nurse leaders
Managers
Administrators
Educators
Policymakers
Worldviews on Evidence-Based Nursing is a primary source of information for using evidence-based nursing practice to improve patient care by featuring:
Knowledge synthesis articles with best practice applications and recommendations for linking evidence to action in real world practice, administra-tive, education and policy settings
Original articles and features that present large-scale studies, which challenge and develop the knowledge base about evidence-based practice in nursing and healthcare
Special features and columns with information geared to readers’ diverse roles: clinical practice, education, research, policy and administration/leadership
Commentaries about current evidence-based practice issues and developments
A forum that encourages readers to engage in an ongoing dialogue on critical issues and questions in evidence-based nursing
Reviews of the latest publications and resources on evidence-based nursing and healthcare
News about professional organizations, conferences and other activities around the world related to evidence-based nursing
Links to other global evidence-based nursing resources and organizations.
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