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Association Between Nursing Workload and Intensive Care Unit Readmissions: A Prospective Cohort Study.

Jérôme Tack1,2, Arnaud Bruyneel1, Julie Maes3

  • 1Research Center in Health Economics, Management of Health Care Institutions and Nursing Sciences, School of Public Health, Free University of Brussels, Brussels, Belgium.

Journal of Advanced Nursing
|April 16, 2025
PubMed
Summary

High nursing workload at intensive care unit (ICU) discharge is linked to increased patient readmission risk. Assessing nursing workload upon ICU discharge is crucial for improving patient care and preventing readmissions.

Keywords:
dischargeintensive care unitnursing activities scorereadmissionworkload

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Area of Science:

  • Critical Care Medicine
  • Nursing Science
  • Health Services Research

Background:

  • Patient readmission after intensive care unit (ICU) discharge poses a significant challenge in healthcare.
  • Understanding factors contributing to unplanned readmissions is essential for improving patient outcomes and optimizing resource allocation.

Purpose of the Study:

  • To investigate the association between nursing workload at the time of ICU discharge and the subsequent risk of patient readmission.
  • To identify nursing workload as a potential predictor of unplanned ICU readmissions.

Main Methods:

  • A prospective cohort study was conducted at a Belgian academic hospital from June 2021 to May 2022.
  • The Nursing Activities Score (NAS) was used to quantify nursing workload during ICU stays and at discharge.
  • Adult patients with ICU stays exceeding 24 hours were included, with exclusions for those discharged to facilities without follow-up capability.

Main Results:

  • Of 1293 eligible admissions, 10.3% resulted in readmission.
  • Readmitted patients had higher mortality rates and longer hospital stays.
  • A higher Nursing Activities Score at ICU discharge was independently associated with an increased risk of 30-day readmission.

Conclusions:

  • Elevated nursing workload at ICU discharge, measured by the NAS, is a significant predictor of patient readmission.
  • Assessing nursing workload during discharge planning is vital for identifying patients at risk and mitigating readmissions.
  • Findings underscore the need to revise discharge processes to incorporate nursing workload as a critical factor.