Department of Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Basel, Switzerland; Rehabilitation, Ageing and Independent Living (RAIL) research centre, School of Primary and Allied Health Care, Monash University, Frankston, Australia.
Department of Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Basel, Switzerland; Lindenhofgruppe AG, Lindenhof Spital, Bern, Switzerland.
Geriatr Nurs. 2023 Sep-Oct;53:12-18. doi: 10.1016/j.gerinurse.2023.06.015. Epub 2023 Jul 1.
Unplanned hospitalizations from nursing homes (NHs) may be considered potentially avoidable and can result in adverse resident outcomes. There is little information about the relationship between a clinical assessment conducted by a physician or geriatric nurse expert before hospitalization and an ensuing rating of avoidability. This study aimed to describe characteristics of unplanned hospitalizations (admitted residents with at least one night stay, emergency department visits were excluded) and to examine this relationship. We conducted a cohort study in 11 Swiss NHs and retrospectively evaluated data from the root cause analysis of 230 unplanned hospitalizations. A telephone assessment by a physician (p=.043) and the need for further medical clarification and treatment (p=<0.001) were the principal factors related to ratings of avoidability. Geriatric nurse experts can support NH teams in acute situations and assess residents while adjudicating unplanned hospitalizations. Constant support for nurses expanding their clinical role is still warranted.
养老院（NH）的非计划性住院可能被认为是潜在可避免的，并可能导致居民不良后果。关于住院前医生或老年病护士专家进行临床评估与随后的可避免性评估之间的关系，相关信息较少。本研究旨在描述非计划性住院（至少有一个晚上住院的入住居民，不包括急诊就诊）的特征，并对此关系进行研究。我们在瑞士的 11 家 NH 中进行了队列研究，并对 230 例非计划性住院的根本原因分析数据进行了回顾性评估。医生的电话评估（p=.043）和需要进一步的医学澄清和治疗（p=<0.001）是与可避免性评估相关的主要因素。老年病护士专家可以在急性情况下为 NH 团队提供支持，并在评判非计划性住院时评估居民。仍需要为扩大临床角色的护士提供持续支持。
