Inpatient treatment time across disciplines in spinal cord injury rehabilitation

Purpose: To describe the acute care length of stay (ACLOS) of adult patients with traumatic spinal cord injury (TSCI) in Tianjin, China, and identify the associated demographic and clinical factors. Methods: TSCI patients admitted to a general hospital in Tianjin, China from 2004 to 2007 were identified. The predictor variables were demographic and clinical factors, including age, gender, etiology, level of injury, severity, associated injuries, surgery, and complications. The outcome variable was ACLOS. Multivariable linear regression analysis models were used to examine the association between predictor and outcome variables.Results: This study included 631 TSCI patients. The mean ACLOS was 32.4 ± 37.7 days, with a range of 1-294 days. The median number of hospitalization days was 21 days. Admission to a suburban hospital surgery, urinary infection, poorer functional status, pressure ulcers, and associated injuries were significantly associated with ACLOS. Conclusion: This study examined the effect of epidemiological and clinical factors on ACLOS in Tianjin, China. The factors that influenced the ACLOS were different from factors reported in other studies. More studies are needed in China to determine the effect of these factors on ACLOS in TSCI patients and to propose a predictive model.

Section: Introductionmentioning

confidence: 99%

Factors affecting the length of stay of patients with traumatic spinal cord injury in Tianjin, China

Ning

et al. 2013

“…8 The sample was 81% male, 65% white (22% black), 38% married, and mostly not obese (82% had a BMI of <30). Sixty-five percent were employed at the time of injury.…”

Section: Resultsmentioning

confidence: 99%

“…The introductory paper 8 ) provided a measure of the medical severity of illness; a higher CSI score indicates a 'sicker' patient based on physiological symptoms documented for each of a patient's diseases, including comorbidities, at the time of rehabilitation admission and again for the full rehabilitation stay. [14][15][16][17][18] The Functional Independence Measure (FIM ® ) was used to describe a patient's independence in specific motor and cognitive abilities at rehabilitation admission and discharge.…”

Section: Methodsmentioning

confidence: 99%

Nursing bedside education and care management time during inpatient spinal cord injury rehabilitation

Rundquist

Gassaway²,

Bailey

et al. 2011

Self Cite

Background: Nurses are an integral part of the spinal cord injury (SCI) rehabilitation team and provide significant education to the patient and family about the intricacies of living with SCI, as well as help manage the care process.Objective: This is the second in a series of reports by clinical nursing leaders involved in the SCIRehab research project, a multi-center, 5-year study to record and analyze details of SCI inpatient rehabilitation, with focus on descriptions of time spent by nurses on bedside education and care management. Methods: Six hundred patients with traumatic SCI were enrolled at six rehabilitation centers. Nurses providing usual care to patients with SCI documented the content and amount of time spent on each bedside interaction using portable electronic devices with customized software or a newly developed customized page in electronic documentation systems; this included details of education or care management. Patient and injury characteristics, including level and nature of injury, were taken from the medical record. Results: Nursing data for this report were derived from 42 048 shifts of nursing care. The mean total of nursing education and care management per patient was 30.6 hours (range 1.2-126.1, standard deviation (SD) 20.7, median 25.5). The mean number of minutes per week was 264.3 (range 33.2-1253, SD 140.9, median 241.9). The time that nurses spent on each activity was significantly different in each neurological injury group. Fifty percent of care management time was devoted to psychosocial support, while medication, skin care, bladder, bowel, and pain management were the main education topics. Conclusions: Nurses in SCI rehabilitation spend a significant amount of time providing education and psychosocial support to patients and their families. Typically, this is not included in traditional documentation systems. Quantification of these interventions will allow researchers to discern whether there are pertinent associations between the time spent on bedside activities and patient outcomes. The data will also be relevant for patient care planning and acuity staffing.

“…Details of patient demographic and injury characteristics are presented for the sample as a whole and for each of the four injury groups separately in the first article in this SCIRehab series 8 ( Table 1). The sample was 81% male, 65% white, 38% married, mostly not obese (82% had a BMI of <30 kg/m 2 ), 65% were employed at the time of injury, and the patients had an average age of 37 years.…”

Section: Resultsmentioning

confidence: 99%

Social work and case management treatment time during inpatient spinal cord injury rehabilitation

Gassaway¹,

Abeyta

Freeman

et al. 2011

Self Cite

Background: There is a lack of published evidence regarding the amount and type of social work and case management (SW/CM) services that an individual with traumatic spinal cord injury (SCI) receives during acute inpatient rehabilitation. Such information is needed to assist in resource planning, benchmarking, and research on interventions and outcomes. Methods: As part of the SCIRehab study social workers and case managers at six inpatient rehabilitation facilities documented details (including time spent) about the interventions provided to 600 patients with traumatic SCI during acute inpatient rehabilitation. Associations between patient and injury characteristics and time spent on these activities were examined. Results: Patients received a mean total of 10 hours of SW/CM services, with a mean of 72.8 total minutes per week. The majority of the patients received SW/CM time spent on interdisciplinary conferencing on the patient's behalf (96%), discharge planning and services (89%), financial planning (67%), community/inhouse services (66%), supportive counseling (56%), and initial assessment (54%). A minority of the patients received peer advocacy (12%), classes (24%), and education topics (30%). Total hours per stay and minutes per week varied by level of injury group. The most time per week was dedicated to patients with high tetraplegia ASIA Impairment Scale (AIS) A-C and the least to patients with C5-C8 AIS A-C. The patient and injury characteristics studied did not explain the variance seen in time spent on specific SW/CM services. Conclusions: These descriptive data may be helpful in resource planning to anticipate and address individual patient needs and to plan for department-level training and hiring. These data also may pave the way to studying relationships of interventions with patient outcomes.