Influence of socioeconomic factors on discharge disposition following traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States

Hagan, Matthew; Pertsch, Nathan J.; Leary, Owen P.; Ganga, Arjun; Sastry, Rahul; Xi, Kevin; Zheng, Bryan; Behar, Mark; Camara-Quintana, Joaquin; Niu, Tianyi; Sullivan, Patricia Zadnik; Abinader, Jose Fernandez; Telfeian, Albert E.; Gokaslan, Ziya L.; Oyelese, Adetokunbo A.; Fridley, Jared

doi:10.1016/j.xnsj.2022.100186

Cited by 1 publication

(1 citation statement)

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“…About 35%–40% of trauma patients are unable to be discharged home without additional care (Graham et al, 2020; Lumbard et al, 2022). Increased injury severity is associated with discharge to outside care along with other nonmodifiable factors such as older age, female gender, having insurance, and having preexisting comorbidities (Baker et al, 1974; Elkbuli et al, 2021; Hagan et al, 2022; Ingram et al, 2022; James et al, 2018). In contrast, Black race has been found to predict discharge to home rather than further care (Elkbuli et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Nurse-Sensitive Indicators as Predictors of Trauma Patient Discharge Disposition

Silverstein,

Moser,

Rayens

2024

Journal of Trauma Nursing

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BACKGROUND: About 3.5 million trauma patients are hospitalized every year, but 35%–40% require further care after discharge. Nurses’ ability to affect discharge disposition by minimizing the occurrence of nurse-sensitive indicators (catheter-associated urinary tract infection [CAUTI], central line-associated bloodstream infection [CLABSI], and hospital-acquired pressure injury [HAPI]) is unknown. These indicators may serve as surrogate measures of quality nursing care. OBJECTIVE: The purpose of this study was to determine whether nursing care, as represented by three nurse-sensitive indicators (CAUTI, CLABSI, and HAPI), predicts discharge disposition in trauma patients. METHODS: This study was a secondary analysis of the 2021 National Trauma Data Bank. We performed logistic regression analyses to determine the predictive effects of CAUTI, CLABSI, and HAPI on discharge disposition, controlling for participant characteristics. RESULTS: A total of n = 29,642 patients were included, of which n = 21,469 (72%) were male, n = 16,404 (64%) were White, with a mean (SD) age of 44 (14.5) and mean (SD) Injury Severity Score of 23.2 (12.5). We created four models to test nurse-sensitive indicators, both individually and compositely, as predictors. While CAUTI and HAPI increased the odds of discharge to further care by 1.4–1.5 and 2.1 times, respectively, CLABSI was not a statistically significant predictor. CONCLUSIONS: Both CAUTI and HAPI are statistically significant predictors of discharge to further care for patients after traumatic injury. High-quality nursing care to prevent iatrogenic complications can improve trauma patients’ long-term outcomes.

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