A Nurse-Led Bridging Program to Reduce 30-Day Readmissions of Older Patients Discharged From Acute Care Units.
J Am Med Dir Assoc
; 22(6): 1292-1299.e5, 2021 06.
Article
in En
| MEDLINE
| ID: mdl-33229305
ABSTRACT
OBJECTIVES:
Older hospitalized patients are at high risk of early readmissions, requiring the implementation of enhanced coordinated transition programs on discharge. The objective of this study was to evaluate the impact of a nurse-led transition bridging program on the rate of unscheduled readmissions of older patients within 30 days from discharge from geriatric acute care units.DESIGN:
A stepped-wedge cluster randomized trial. SETTING ANDPARTICIPANTS:
Seven hundred five patients aged ≥75 years hospitalized in one of 10 acute geriatric units, with at least 2 readmission risk-screening criteria (derived from the Triage Risk Screening Tool), were included from July 2015 to August 2016.METHODS:
The intervention condition consisted in a nurse-led hospital-to-home bridging program with 4 weeks postdischarge follow-up (2 home visits and 2 telephone calls). Unscheduled hospital readmission or emergency department (ED) visits were compared in intervention and control condition within 30 days from discharge.RESULTS:
The rate of 30-day readmission or ED visit was 15.5% in the intervention condition vs 17.6% in the control condition [hazard ratio stratified on clusters 0.61 (upper limit unilateral 95% confidence interval = 1.11), P = .09]. Rate of presence of professional caregivers was increased in the intervention condition (P < .001). CONCLUSIONS AND IMPLICATIONS Although the intervention resulted in an increase in the rate of implementation of a package of care at the 4-week of follow-up, we could not demonstrate a reduction in the rate of 30-day readmissions or ED visits of older patients at risk of readmission. These findings support the evaluation of this type of program on the longer term.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Patient Discharge
/
Patient Readmission
Type of study:
Clinical_trials
Limits:
Aged
/
Humans
Language:
En
Journal:
J Am Med Dir Assoc
Journal subject:
HISTORIA DA MEDICINA
/
MEDICINA
Year:
2021
Type:
Article