Cardiac acute care nurse practitioner and 30-day readmission

Daniel David, Lorraine Britting, Joanne Dalton

Research output: Contribution to journalArticle

Abstract

Background: The utilization outcomes of nurse practitioners (NPs) in the acute care setting have not been widely studied. Objective: The purpose of this study was to determine the impact on utilization outcomes of NPs on medical teams who take care of patients admitted to a cardiovascular intensive care unit. Methods: A retrospective 2-group comparative design was used to evaluate the outcomes of 185 patients with ST- or non ST-segment elevation myocardial infarction or heart failure who were admitted to a cardiovascular intensive care unit in an urban medical center. Patients received care from a medical team that included a cardiac acute care NP (n = 109) or medical team alone (n = 76). Patient history, cardiac assessment, medical interventions, discharge disposition, discharge time, and 3 utilization outcomes (ie, length of stay, 30-day readmission, and time of discharge) were compared between the 2 treatment groups. Logistic regression was used to identify predictors of 30-day readmission. Results: Patients receiving care from a medical team that included an NP were rehospitalized approximately 50% less often compared with those receiving care from a medical team without an NP. Thirty-day hospital readmission (P =.011) and 30-day return rates to the emergency department (P =.021) were significantly lower in the intervention group. Significant predictors for rehospitalization included diagnosis of heart failure versus myocardial infarction (odds ratio [OR], 3.153, P = 0.005), treatment by a medical team without NP involvement (OR, 2.905, P = 0.008), and history of diabetes (OR, 2.310, P = 0.032). Conclusions: The addition of a cardiac acute care NP to medical teams caring for myocardial infarction and heart failure patients had a positive impact on 30-day emergency department return and hospital readmission rates.

Original languageEnglish (US)
Pages (from-to)248-255
Number of pages8
JournalJournal of Cardiovascular Nursing
Volume30
Issue number3
DOIs
StatePublished - May 27 2015

Keywords

  • acute coronary syndrome
  • heart failure
  • hospital readmission
  • nurse practitioner
  • outcomes assessment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Fingerprint Dive into the research topics of 'Cardiac acute care nurse practitioner and 30-day readmission'. Together they form a unique fingerprint.

  • Cite this