Granda-Cameron Clara, Behta Maryam, Hovinga Mary, Rundio Al, Mintzer David
Abramson Cancer Center at Pennsylvania Hospital in Philadelphia.
Oncol Nurs Forum. 2015 May;42(3):E257-68. doi: 10.1188/15.ONF.E257-E268.
PURPOSE/OBJECTIVES: To identify risk factors associated with 30-day unplanned hospital readmissions in adults with cancer.
Case-control study.
A teaching hospital in an urban center in the Mid-Atlantic region of the United States.
302 adults with solid tumors.
The Conceptual Model of Re-Hospitalization was used as a theoretic framework. Univariate logistic regression and multivariate logistic regression were conducted to identify risk factors for hospital readmission.
Risk factors included patient, clinical, hospitalization, and discharge-planning characteristics.
From November 2011 to November 2012, 29% of patients were readmitted within 30 days after discharge, and a higher percentage of those readmissions occurred within the first week of discharge. Several predictors for hospital readmission were identified in the univariate logistic analysis, but the most relevant in the final multivariate logistic model were moderate to high risk for falls and advanced stage disease (metastatic).
Hospital readmission is an indicator of quality care. Learning about risk factors allows opportunities to prevent hospital readmission by identifying those at high risk and implementing optimal discharge-planning systems and early referrals to palliative care.
Oncology nurses are best positioned to develop strategic plans aimed at improving discharge planning and transitions of care that will decrease unplanned hospital readmissions.
目的/目标：确定成年癌症患者30天内非计划再次入院的相关危险因素。
病例对照研究。
美国中大西洋地区城市中心的一家教学医院。
302例实体瘤成年患者。
将再入院概念模型用作理论框架。采用单因素逻辑回归和多因素逻辑回归来确定再次入院的危险因素。
危险因素包括患者、临床、住院和出院计划特征。
2011年11月至2012年11月，29%的患者在出院后30天内再次入院，且较高比例的再入院发生在出院后的第一周内。单因素逻辑分析确定了几个再次入院的预测因素，但最终多因素逻辑模型中最相关的是中度至高度跌倒风险和晚期疾病（转移性）。
再次入院是护理质量的一个指标。了解危险因素有助于通过识别高危人群、实施最佳出院计划系统以及早期转诊至姑息治疗来预防再次入院。
肿瘤护士最有能力制定旨在改善出院计划和护理过渡的战略计划，以减少非计划再次入院。
