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Nurse Continuity and Hospital-Acquired Pressure Ulcers: A Comparative Analysis Using an Electronic Health Record "Big
Janet Stifter1, Yingwei Yao, Muhammad Kamran Lodhi
1Janet Stifter, PhD, RN, is Postdoctoral Scholar, College of Nursing, University of Illinois at Chicago. Yingwei Yao, PhD, is Research Associate Professor, College of Nursing, University of Illinois at Chicago, and College of Nursing, University of Florida, Gainesville. Muhammad Kamran Lodhi, BS, is PhD Candidate, University of Illinois at Chicago Electrical and Computer Engineering. Karen Dunn Lopez, PhD, MPH, RN, is Assistant Professor, College of Nursing, University of Illinois at Chicago. Ashfaq Khokhar, PhD, is Professor, Illinois Institute of Technology, Chicago. Diana J. Wilkie, PhD, RN, FAAN, is Earl and Margo Powers Endowed Professor, College of Nursing, University of Florida at Gainesville, and was the Harriet J. Werley Endowed Chair for Nursing Research, College of Nursing, University of Illinois at Chicago. Gail M. Keenan, PhD, RN, FAAN, is Professor and Annabel Jenks Davis Endowed Chair, College of Nursing, University of Florida at Gainesville, and was a Professor, College of Nursing, University of Illinois at Chicago.
Nurse continuity did not prevent hospital-acquired pressure ulcers (HAPUs). Patient factors like nutrition and mobility were linked to HAPUs, not the consistency of nursing care.
Area of Science:
- Nursing Science
- Patient Safety Research
- Health Informatics
Background:
- Limited research exists on the link between nurse continuity and patient outcomes.
- There is an intuitive belief that consistent nursing care improves patient outcomes.
Purpose of the Study:
- To investigate the association between nurse continuity and the prevention of hospital-acquired pressure ulcers (HAPUs).
Main Methods:
- Utilized a secondary data analysis of the Hands on Automated Nursing Data System (HANDS), a large nursing care dataset.
- Created a matched analytic dataset of 840 care episodes (210 HAPU, 630 non-HAPU) using data mining techniques.
- Employed logistic regression to analyze the relationship between nurse continuity, staffing variables, and HAPU occurrence.
Main Results:
- All nine units studied exhibited poor nurse continuity (mean continuity index of 0.21-0.42).
- Patient factors including nutrition, mobility, perfusion, hydration, skin condition, and age were significantly associated with HAPUs (p < .001).
- Nurse continuity and its interactions with staffing variables were not significantly associated with HAPU development after controlling for patient characteristics.
Conclusions:
- Patient characteristics, not nurse continuity, were significantly associated with hospital-acquired pressure ulcers.
- The HANDS data revealed substantial variation in nurse continuity, indicating potential for future research on its impact on patient outcomes.
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