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Predictive factors of a prolonged length of stay in a community Nursing‐Led unit: A retrospective cohort study

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Listed:
  • Valentina Zeffiro
  • Gianfranco Sanson
  • John Welton
  • Massimo Maurici
  • Anna Malatesta
  • Luigia Carboni
  • Ercole Vellone
  • Rosaria Alvaro
  • Fabio D’Agostino

Abstract

Aims and objectives To describe the care provided to patients admitted into a community Nursing‐Led inpatient unit and to identify factors predicting a length of stay exceeding an established threshold. Background Few studies have been conducted to describe the care provided in a Nursing‐Led unit. No studies have investigated factors affecting length of stay in these services. Design Retrospective cohort study. Methods Consecutive patients admitted to a community Nursing‐Led unit between 2009–2015 were enrolled. Sociodemographic, medical and nursing care (diagnoses and activities) variables were collected from electronic health records. Descriptive analysis and a backward stepwise logistic regression model were applied. The study followed the STROBE guidelines. Results The study enrolled 904 patients (mean age: 77.7 years). The most frequent nursing diagnoses were bathing self‐care deficit and impaired physical mobility. The nursing activities most provided were enteral medication administration and vital signs measurement. Approximately 37% of the patients had a length of stay longer than the established threshold. Nine covariates, including being discharged to home, having an impaired memory nursing diagnosis or being treated for advanced wound care, were found to be independent predictors of prolonged length of stay. Variables related to medical conditions did not affect the length‐of‐stay threshold. Conclusions The length of stay in the community Nursing‐Led unit was mainly predicted by conditions related to sociodemographic factors, nursing complexity and functional status. This result confirms that the medical and nursing needs of a community Nursing‐Led unit population substantively differ from those of hospitalised acute patients. Relevance to clinical practice The nursing complexity and related nursing care to be provided may be adopted as a criterion to establish the appropriate length of stay in the community Nursing‐Led unit for each individual patient.

Suggested Citation

  • Valentina Zeffiro & Gianfranco Sanson & John Welton & Massimo Maurici & Anna Malatesta & Luigia Carboni & Ercole Vellone & Rosaria Alvaro & Fabio D’Agostino, 2020. "Predictive factors of a prolonged length of stay in a community Nursing‐Led unit: A retrospective cohort study," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(23-24), pages 4685-4696, December.
    • Handle: RePEc:wly:jocnur:v:29:y:2020:i:23-24:p:4685-4696
    DOI: 10.1111/jocn.15509
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    References listed on IDEAS

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    1. Livio Garattini & Alessandro Curto & Nick Freemantle, 2016. "Access to primary care in Italy: time for a shake-up?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 113-116, March.
    2. Gianfranco Sanson & Ercole Vellone & Mari Kangasniemi & Rosaria Alvaro & Fabio D'Agostino, 2017. "Impact of nursing diagnoses on patient and organisational outcomes: a systematic literature review," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(23-24), pages 3764-3783, December.
    3. Wei‐Chun Lin & Su‐Chuan Yuan & Jung‐Yien Chien & Shuo‐Chun Weng & Ming‐Chih Chou & Hsien‐Wen Kuo, 2012. "The effects of respiratory training for chronic obstructive pulmonary disease patients: a randomised clinical trial," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(19pt20), pages 2870-2878, October.
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