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

Schreuders, Louise Winton, Bremner, Alexandra P., Geelhoed, Elizabeth and Finn, Judith (2014) Using linked hospitalisation data to detect nursing sensitive outcomes: a retrospective cohort study. International Journal of Nursing Studies, 51 3: 470-478. doi:10.1016/j.ijnurstu.2013.06.006

Author Schreuders, Louise Winton
Bremner, Alexandra P.
Geelhoed, Elizabeth
Finn, Judith
Title Using linked hospitalisation data to detect nursing sensitive outcomes: a retrospective cohort study
Journal name International Journal of Nursing Studies   Check publisher's open access policy
ISSN 0020-7489
Publication date 2014-03-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.ijnurstu.2013.06.006
Open Access Status Not yet assessed
Volume 51
Issue 3
Start page 470
End page 478
Total pages 9
Place of publication Bromley, United Kingdom
Publisher Elsevier
Language eng
Formatted abstract
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 may be 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.
Keyword Care, nursing
Medical record linkage
Nursing methodology research
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Nursing, Midwifery and Social Work Publications
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Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
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Created: Sat, 12 Jul 2014, 00:09:24 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work