{"title":"Associations Between Nurse Staffing Levels and 30- and 60-Day Readmissions for Acute Care Patients With Intellectual and Developmental Disability.","authors":"Lynne S Moronski, Eileen T Lake, Matthew D McHugh","doi":"10.1002/nur.70013","DOIUrl":null,"url":null,"abstract":"<p><p>The purpose of this study was to examine the association between hospital nurse staffing levels and 30- and 60-day readmissions among patients with intellectual and/or developmental disabilities (IDD). This cross-sectional correlational study utilized secondary data from 595 acute care, nonfederal hospitals in California, Florida, New Jersey, and Pennsylvania in 2016. Data were obtained from three sources: the American Hospital Association Annual Survey, the RN4CAST-US nurse survey, and state patient hospital discharge summaries. The analytic sample included 39,558 hospital stays for 28,446 adults with IDD aged 18 and older who were discharged alive. In adjusted models, every additional patient added to a nurse's workload was associated with 7% higher odds of 30-day readmission OR = 1.07 (95% CI [1.03, 1.12], p = 0.001) and 9% higher odds of 60-day readmission OR = 1.09 (95% CI [1.04, 1.13], p < 0.001) among patients with IDD. The average nurse staffing level across hospitals was 4.7 patients per nurse (SD = 0.99). Staffing levels varied by hospital characteristics, with large hospitals, major teaching hospitals, and hospitals in California having better staffing ratios. The study population had a 30-day readmission rate of 17.1%, which is 27% higher than the average adult hospital 30-day readmission rate in the US in 2018. This study demonstrates the association of nurse staffing levels with readmission odds for patients with IDD. Improving nurse staffing levels is a system-based solution that can potentially improve outcomes for patients with IDD, who often require intensive nursing care.</p>","PeriodicalId":54492,"journal":{"name":"Research in Nursing & Health","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research in Nursing & Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/nur.70013","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
The purpose of this study was to examine the association between hospital nurse staffing levels and 30- and 60-day readmissions among patients with intellectual and/or developmental disabilities (IDD). This cross-sectional correlational study utilized secondary data from 595 acute care, nonfederal hospitals in California, Florida, New Jersey, and Pennsylvania in 2016. Data were obtained from three sources: the American Hospital Association Annual Survey, the RN4CAST-US nurse survey, and state patient hospital discharge summaries. The analytic sample included 39,558 hospital stays for 28,446 adults with IDD aged 18 and older who were discharged alive. In adjusted models, every additional patient added to a nurse's workload was associated with 7% higher odds of 30-day readmission OR = 1.07 (95% CI [1.03, 1.12], p = 0.001) and 9% higher odds of 60-day readmission OR = 1.09 (95% CI [1.04, 1.13], p < 0.001) among patients with IDD. The average nurse staffing level across hospitals was 4.7 patients per nurse (SD = 0.99). Staffing levels varied by hospital characteristics, with large hospitals, major teaching hospitals, and hospitals in California having better staffing ratios. The study population had a 30-day readmission rate of 17.1%, which is 27% higher than the average adult hospital 30-day readmission rate in the US in 2018. This study demonstrates the association of nurse staffing levels with readmission odds for patients with IDD. Improving nurse staffing levels is a system-based solution that can potentially improve outcomes for patients with IDD, who often require intensive nursing care.
本研究的目的是研究医院护士配备水平与智力和/或发育性残疾（IDD）患者30天和60天再入院之间的关系。这项横断面相关性研究利用了2016年来自加利福尼亚州、佛罗里达州、新泽西州和宾夕法尼亚州595家急症护理非联邦医院的二次数据。数据来自三个来源：美国医院协会年度调查、RN4CAST-US护士调查和州患者出院摘要。分析样本包括28,446名18岁及以上的IDD成人的39,558次住院，他们活着出院。在调整后的模型中，每增加一名护士的工作量，30天再入院的几率就会增加7%，OR = 1.07 (95% CI [1.03, 1.12], p = 0.001)， 60天再入院的几率会增加9%，OR = 1.09 (95% CI [1.04, 1.13], p
期刊介绍：
Research in Nursing & Health ( RINAH ) is a peer-reviewed general research journal devoted to publication of a wide range of research that will inform the practice of nursing and other health disciplines. The editors invite reports of research describing problems and testing interventions related to health phenomena, health care and self-care, clinical organization and administration; and the testing of research findings in practice. Research protocols are considered if funded in a peer-reviewed process by an agency external to the authors’ home institution and if the work is in progress. Papers on research methods and techniques are appropriate if they go beyond what is already generally available in the literature and include description of successful use of the method. Theory papers are accepted if each proposition is supported by research evidence. Systematic reviews of the literature are reviewed if PRISMA guidelines are followed. Letters to the editor commenting on published articles are welcome.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
