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Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings

Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings
Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings

Aims: to identify the costs associated with nurse sensitive adverse events and the impact of these events on patients' length of stay.

Design: retrospective cohort study using administrative hospital data.

Methods: data were sourced from patient discharge information (N = 5544) from six acute wards within three hospitals (July 2016-October 2017). A retrospective patient record review was undertaken by extracting data from the hospitals' administrative systems on inpatient discharges, length of stay and diagnoses; eleven adverse events sensitive to nurse staffing were identified within the administrative system. A negative binomial regression is employed to assess the impact of nurse sensitive adverse events on length of stay.

Results: sixteen per cent of the sample (n = 897) had at least one nurse sensitive adverse event during their episode of care. The model revealed when age, gender, admission type and complexity are controlled for, each additional nurse sensitive adverse event experienced by a patient was associated with an increase in the length of stay beyond the national average by 0.48 days (p = .001). Applying this to the daily average cost of inpatient stay per patient (€1456), we estimate the average cost associated with each nurse sensitive adverse event to be €694. Extrapolating this nationally, the economic cost of nurse sensitive adverse events to the health service in Ireland is estimated to be €91.3 million annually.

Conclusion: these potentially avoidable events are associated with a significant economic burden to health systems. The estimates provided here can be used to inform and prepare the way for future economic evaluations of nurse staffing initiatives that aim to improve care and safety.

Impact: as many of these nurse sensitive adverse events are avoidable, in addition to patient benefits, there is a potential substantial financial return on investment from strategies such as improved nurse staffing that can reduce their occurrence.

Hospitals, Humans, Ireland, Nursing Staff, Hospital, Personnel Staffing and Scheduling, Retrospective Studies, Workforce
0309-2402
3379-3388
Murphy, Aileen
fad0929d-15ba-4100-bb92-2407547dc5d4
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Duffield, Christine
61eb8ec8-09ea-4a45-a5bf-1660cf58ab1c
Brady, Noeleen M
6c107dc2-e528-40ca-9f33-1c08589f5954
Scott, Anne Philomena
11ccbec5-860a-47c9-9753-6fe00cc5ec7a
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
Drennan, Jonathan
dad7b3ad-8b7d-428b-8dea-ccb1d50819eb
Murphy, Aileen
fad0929d-15ba-4100-bb92-2407547dc5d4
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Duffield, Christine
61eb8ec8-09ea-4a45-a5bf-1660cf58ab1c
Brady, Noeleen M
6c107dc2-e528-40ca-9f33-1c08589f5954
Scott, Anne Philomena
11ccbec5-860a-47c9-9753-6fe00cc5ec7a
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
Drennan, Jonathan
dad7b3ad-8b7d-428b-8dea-ccb1d50819eb

Murphy, Aileen, Griffiths, Peter, Duffield, Christine, Brady, Noeleen M, Scott, Anne Philomena, Ball, Jane and Drennan, Jonathan (2021) Estimating the economic cost of nurse sensitive adverse events amongst patients in medical and surgical settings. Journal of Advanced Nursing, 77 (8), 3379-3388. (doi:10.1111/jan.14860).

Record type: Article

Abstract

Aims: to identify the costs associated with nurse sensitive adverse events and the impact of these events on patients' length of stay.

Design: retrospective cohort study using administrative hospital data.

Methods: data were sourced from patient discharge information (N = 5544) from six acute wards within three hospitals (July 2016-October 2017). A retrospective patient record review was undertaken by extracting data from the hospitals' administrative systems on inpatient discharges, length of stay and diagnoses; eleven adverse events sensitive to nurse staffing were identified within the administrative system. A negative binomial regression is employed to assess the impact of nurse sensitive adverse events on length of stay.

Results: sixteen per cent of the sample (n = 897) had at least one nurse sensitive adverse event during their episode of care. The model revealed when age, gender, admission type and complexity are controlled for, each additional nurse sensitive adverse event experienced by a patient was associated with an increase in the length of stay beyond the national average by 0.48 days (p = .001). Applying this to the daily average cost of inpatient stay per patient (€1456), we estimate the average cost associated with each nurse sensitive adverse event to be €694. Extrapolating this nationally, the economic cost of nurse sensitive adverse events to the health service in Ireland is estimated to be €91.3 million annually.

Conclusion: these potentially avoidable events are associated with a significant economic burden to health systems. The estimates provided here can be used to inform and prepare the way for future economic evaluations of nurse staffing initiatives that aim to improve care and safety.

Impact: as many of these nurse sensitive adverse events are avoidable, in addition to patient benefits, there is a potential substantial financial return on investment from strategies such as improved nurse staffing that can reduce their occurrence.

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Published date: 1 August 2021
Keywords: Hospitals, Humans, Ireland, Nursing Staff, Hospital, Personnel Staffing and Scheduling, Retrospective Studies, Workforce

Identifiers

Local EPrints ID: 456591
URI: http://eprints.soton.ac.uk/id/eprint/456591
ISSN: 0309-2402
PURE UUID: 9b152358-0514-4ec1-ae20-7b87ff534420
ORCID for Peter Griffiths: ORCID iD orcid.org/0000-0003-2439-2857
ORCID for Jane Ball: ORCID iD orcid.org/0000-0002-8655-2994
ORCID for Jonathan Drennan: ORCID iD orcid.org/0000-0001-7365-4345

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Date deposited: 05 May 2022 16:44
Last modified: 17 Mar 2024 03:37

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Contributors

Author: Aileen Murphy
Author: Peter Griffiths ORCID iD
Author: Christine Duffield
Author: Noeleen M Brady
Author: Anne Philomena Scott
Author: Jane Ball ORCID iD

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