Predictive factors of a prolonged length of stay in a community Nursing‐Led unit: A retrospective cohort study

Zeffiro, Valentina; Sanson, Gianfranco; Welton, John; Maurici, Massimo; Malatesta, Anna; Carboni, Luigia; Vellone, Ercole; Alvaro, Rosaria; D’Agostino, F

doi:10.1111/jocn.15509

Cited by 6 publications

(1 citation statement)

References 53 publications

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“…Nursing diagnoses NANDA‐I were also a strong independent predictor of “deviation length of stay” (i.e., the difference between the effective length of stay and the DRGs‐specific national expected average hospital length of stay) (D'Agostino et al, 2019). Longer than expected length of stay was more likely associated with each additional nursing diagnosis NANDA‐I in both a hospital setting (O'Brien‐Pallas et al, 2010) and a community nursing‐led unit (Zeffiro et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

Impact of standardized nursing terminologies on patient and organizational outcomes: A systematic review and meta‐analysis

Bertocchi

Dante

Cerra

et al. 2023

J of Nursing Scholarship

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AimsTo explore the impact of 12 American Nurses Association recognized standardized nursing terminologies (SNTs) on patient and organizational outcomes.BackgroundPrevious studies reported an effect of SNTs on outcomes, but no previous frameworks nor meta‐analyses were found.DesignSystematic review and meta‐analyses.Review MethodsPubMed, Scopus, CINAHL, and OpenGrey databases were last consulted in July 2021. All abstracts and full texts were screened independently by two researchers. The review included primary quantitative studies that reported an association between recognized SNTs and outcomes. Two reviewers independently assessed the risk of bias and certainty of evidence for each meta‐analyzed outcome using the “Grading of Recommendations, Assessment, Development and Evaluation” (GRADE) approach.ResultsFifty‐three reports were included. NANDA‐NIC‐NOC and Omaha System were the most frequently reported SNTs used in the studies. Risk of bias in randomized controlled trials and not‐randomized controlled trials ranged from high to unclear, this risk was low in cross‐sectional studies. The number of nursing diagnoses NANDA‐I moderately correlated with the intensive care unit length of stay (r = 0.38; 95% CI = 0.31–0.44). Using the Omaha System nurse‐led transitional care program showed a large increase in both knowledge (d = 1.21; 95% CI = 0.97–1.44) and self‐efficacy (d = 1.23; 95% CI = 0.97–1.48), while a reduction on the readmission rate (OR = 0.46; 95% CI = 0.09–0.83). Nursing diagnoses were found to be useful predictors for organizational (length of stay) and patients' outcomes (mortality, quality of life). The GRADE indicated that the certainty of evidence was rated from very low to low.ConclusionsStudies using SNTs demonstrated significant improvement and prediction power in several patients' and organizational outcomes. Further high‐quality research is required to increase the certainty of evidence of these relationships.Clinical relevanceSNTs should be considered by healthcare policymakers to improve nursing care and as essential reporting data about patient's nursing complexity to guide reimbursement criteria.

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Section: Resultsmentioning

confidence: 99%

Impact of standardized nursing terminologies on patient and organizational outcomes: A systematic review and meta‐analysis

Bertocchi

Dante

Cerra

et al. 2023

J of Nursing Scholarship

View full text Add to dashboard Cite

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Can an increase in nursing care complexity raise the risk of intra-hospital and intensive care unit transfers in children? A retrospective observational study

Cesare,

Cocchieri

2025

Journal of Pediatric Nursing

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Exploring the Impact of Medical Complexity on Nursing Complexity of Care in Paediatric Patients: A Retrospective Observational Study

Cesare,

D' Agostino,

Damiani

et al. 2024

Journal of Clinical Nursing

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AimsTo explore the impact of medical complexity, defined by the number of chronic conditions, on the complexity of care, as described by the frequency of nursing diagnoses (NDs) and nursing actions (NAs), in paediatric patients.DesignRetrospective observational study.MethodsThis study was conducted in an Italian university hospital and involved the analysis of electronic health records for neonatal and paediatric patients who were consecutively admitted from January to December 2022. The sample was classified into three categories—non‐chronic, single chronic and multimorbid patients—according to their clinical profiles. NDs recorded within the first 24 h from patient hospital admission and NAs performed throughout the hospital stay were counted for each group.ResultsDistinct variations in the prevalence and patterns of NDs and NAs were observed across different levels of medical complexity. A significant moderate positive correlation between the number of NDs and NAs was found. However, the frequency of NDs did not directly correlate with the number of chronic conditions. Conversely, a weak but significant negative correlation was identified between the quantity of NAs and the number of chronic conditions. While the frequency of NDs showed a stable but decreasing trend as the number of chronic conditions increased, a higher number of chronic conditions were associated with a lower quantity of NAs.ConclusionsWe discovered a notable variation in the complexity of care across varying levels of medical complexity in paediatric patients. Our findings suggest that the complexity of care does not necessarily correspond to the degree of medical complexity. The observed negative relationship between the number of chronic conditions and the quantity of NAs underscores the need for further research to explore this unexpected finding and its implications for clinical practice.Implications for the Profession and/or Patient CareWithout the adoption of standardised nursing terminologies, such as nursing diagnoses (NDs) and nursing actions (NAs), assessing the complexity of care in paediatric settings can be challenging. Integrating clinical nursing information systems that incorporate standardised NDs and NAs into electronic health records is crucial for accurately documenting and analysing the complexity of care and its relationship with medical complexity.Impact In paediatric patients, the frequency of nursing diagnoses (NDs) at hospital admission is significantly associated with the quantity of nursing actions (NAs) delivered during hospitalisation. However, there is no correlation between the frequency of NDs and medical complexity, as defined by the number of chronic disorders. Specifically, the frequency of NDs decreases with increasing medical complexity, while the quantity of NAs is negatively associated with the number of chronic disorders. This indicates that the complexity of care cannot be inferred solely from medical complexity, and additional factors need to be explored. These findings enhance understanding of how complexity of care relates to medical complexity in paediatric patients. Insights into the prevalence and patterns of NDs and NAs can benefit nurses, managers, researchers and policymakers by informing clinical and organisational decision‐making to ensure high‐quality care. Reporting MethodThe study adhered to the RECORD Statement.Patient or Public ContributionPatients, service users, caregivers or public members were not directly involved in the design, conduct, analysis and interpretation of data or in writing this paper. Patients contributed only to data collection.

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Predictive factors of a prolonged length of stay in a community Nursing‐Led unit: A retrospective cohort study

Cited by 6 publications

References 53 publications

Impact of standardized nursing terminologies on patient and organizational outcomes: A systematic review and meta‐analysis

Impact of standardized nursing terminologies on patient and organizational outcomes: A systematic review and meta‐analysis

Can an increase in nursing care complexity raise the risk of intra-hospital and intensive care unit transfers in children? A retrospective observational study

Exploring the Impact of Medical Complexity on Nursing Complexity of Care in Paediatric Patients: A Retrospective Observational Study

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