Nurse-Sensitive Indicators as Predictors of Trauma Patient Discharge Disposition.

IF 0.7 4区 医学 Q4 CRITICAL CARE MEDICINE
Journal of Trauma Nursing Pub Date : 2024-07-01 Epub Date: 2024-07-04 DOI:10.1097/JTN.0000000000000797
Lily A Silverstein, Debra K Moser, Mary Kay Rayens
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引用次数: 0

Abstract

Background: About 3.5 million trauma patients are hospitalized every year, but 35%-40% require further care after discharge. Nurses' ability to affect discharge disposition by minimizing the occurrence of nurse-sensitive indicators (catheter-associated urinary tract infection [CAUTI], central line-associated bloodstream infection [CLABSI], and hospital-acquired pressure injury [HAPI]) is unknown. These indicators may serve as surrogate measures of quality nursing care.

Objective: The purpose of this study was to determine whether nursing care, as represented by three nurse-sensitive indicators (CAUTI, CLABSI, and HAPI), predicts discharge disposition in trauma patients.

Methods: This study was a secondary analysis of the 2021 National Trauma Data Bank. We performed logistic regression analyses to determine the predictive effects of CAUTI, CLABSI, and HAPI on discharge disposition, controlling for participant characteristics.

Results: A total of n = 29,642 patients were included, of which n = 21,469 (72%) were male, n = 16,404 (64%) were White, with a mean (SD) age of 44 (14.5) and mean (SD) Injury Severity Score of 23.2 (12.5). We created four models to test nurse-sensitive indicators, both individually and compositely, as predictors. While CAUTI and HAPI increased the odds of discharge to further care by 1.4-1.5 and 2.1 times, respectively, CLABSI was not a statistically significant predictor.

Conclusions: Both CAUTI and HAPI are statistically significant predictors of discharge to further care for patients after traumatic injury. High-quality nursing care to prevent iatrogenic complications can improve trauma patients' long-term outcomes.

作为创伤患者出院处置预测因素的护士敏感指标。
背景:每年约有 350 万名创伤患者住院治疗,但其中 35%-40% 的患者出院后需要进一步治疗。护士能否通过减少护士敏感指标(导尿管相关尿路感染 [CAUTI]、中心静脉相关血流感染 [CLABSI] 和医院获得性压伤 [HAPI])的发生来影响出院处置尚不清楚。这些指标可作为优质护理的替代衡量标准:本研究的目的是确定以三个护士敏感指标(CAUTI、CLABSI 和 HAPI)为代表的护理是否能预测创伤患者的出院处置:本研究是对 2021 年国家创伤数据库的二次分析。我们进行了逻辑回归分析,以确定 CAUTI、CLABSI 和 HAPI 对出院处置的预测效果,同时控制参与者的特征:共纳入 n = 29,642 名患者,其中男性 n = 21,469 人(72%),白人 n = 16,404 人(64%),平均(标清)年龄为 44(14.5)岁,平均(标清)损伤严重程度评分为 23.2(12.5)分。我们创建了四个模型来测试作为预测因子的护士敏感指标,包括单独指标和综合指标。CAUTI和HAPI分别将出院接受进一步护理的几率提高了1.4-1.5倍和2.1倍,而CLABSI则不是一个具有统计学意义的预测指标:结论:CAUTI 和 HAPI 对创伤后患者出院后接受进一步护理的预测均具有统计学意义。预防先天性并发症的高质量护理可改善创伤患者的长期预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Trauma Nursing
Journal of Trauma Nursing CRITICAL CARE MEDICINENURSING&-NURSING
CiteScore
1.20
自引率
10.00%
发文量
106
期刊介绍: ​Journal of Trauma Nursing (JTN) is the official journal of the Society of Trauma Nurses. The Society of Trauma Nurses believes that trauma is a disease impacting patients through the continuum of care. The mission of STN is to ensure optimal trauma care through education, collaboration, leadership and membership engagement. As the official publication of the Society of Trauma Nurses, the Journal of Trauma Nursing supports the STN’s strategic goals of effective communication, education and patient advocacy with original, peer-reviewed, research and evidence-based articles and information that reflect the highest standard of collaborative care for trauma patients.​ The Journal of Trauma Nursing, through a commitment to editorial excellence, implements STN’s vision to improve practice and patient outcomes and to become the premiere global nursing organization across the trauma continuum.
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