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

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.