Nav: Home

'Unmet nursing care' may contribute to racial disparities in rehospitalizations after heart attack

April 14, 2016

April 14, 2016 - Why are black older adults at higher risk of repeat hospital admission after a heart attack? Treatment at hospitals with higher rates of missed nursing care may be a contributing factor, reports a study in the May issue of Medical Care. The journal is published by Wolters Kluwer.

"Our findings suggest that unmet nursing care varies widely across US hospitals and that older blacks disproportionately receive care in settings where care is missed more often," comments lead author J. Margo Brooks-Carthon, PhD, RN, of University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy Research. "As the nation continues to intensify efforts to reduce health disparities, solutions may lie in ensuring adequate resources to nurses working in direct care."

Some Forms of Unmet Nursing Care Linked to Increased Readmission Risk

The researchers analyzed data on more than 69,000 black and white patients with acute myocardial infarction (AMI) treated at 253 hospitals in three states during 2006-07. Each hospital was classified in terms of how often necessary nursing care tasks were left incomplete due to a lack of time.

The study looked at differences in the characteristics of hospitals where black versus white patients were treated, including whether nursing care needs were unmet "rarely, sometimes, or frequently." This measure of unmet nursing care was also analyzed as a risk factor for repeat hospital admission within 30 days after AMI.

On average, black patients were younger but had more health problems than white patients; they also had lower socioeconomic status. Consistent with previous studies, the 30-day readmission rate was higher in black patients: 23.5 percent, compared to 18.8 percent in white patients.

"In general, older black patients were more often in hospitals where necessary care was omitted, and less often in the hospitals where care was rarely missed," says Dr. Brooks-Carthon. Unmet nursing care was associated with a higher risk of repeat admission for black patients, after adjustment for patient and hospital characteristics.

The strongest factor was not receiving medications in a timely manner. For black patients with this form of unmet nursing care, the odds of readmission were increased by 26 percent. Readmission was also more likely when nurses omitted comforting and talking with patients, a nine percent increase in risk; and when they didn't document care, a six percent increase.

Surprisingly, some other types of unmet nursing care--such as discharge planning and patient education--were not significantly related to readmission risk. Unmet nursing care did not influence the likelihood of readmission for older white patients.

Nurses play a critical role in caring for patients after AMI. However, nurses are increasingly unable to complete all necessary care tasks--especially as they spend more time on administrative tasks and less on direct patient care. The new study is the first to assess whether unmet nursing care contributes to racial/ethnic differences in AMI readmissions. The results may help to inform ongoing efforts to improve the outcome of older minority patients by improving care transitions from hospitals to outpatient settings.

"Our findings suggest that older Black AMI patients endure greater consequences when nursing tasks are left incomplete," Dr. Brooks-Carthon- adds. The researchers conclude, "Any efforts to reduce readmission disparities must include investments to ensure that nurses who work on the front lines of care can attend to the complex social and healthcare needs of this population."
-end-
The study was supported by the Robert Wood Johnson Foundation Nurse Faculty Scholars Program (71249) and National Institute of Nursing Research (R01-NR04513, T32-NR0714).

Click here to read "Unmet Nursing Care Linked to Rehospitalizations Among Older Black AMI Patients: A Cross-Sectional Study of US Hospitals."

Article: "Unmet Nursing Care Linked to Rehospitalizations Among Older Black AMI Patients: A Cross-Sectional Study of US Hospitals" (doi: 10.1097/MLR.0000000000000519)

About Medical Care

Rated as one of the top ten journals in health care administration, Medical Care is devoted to all aspects of the administration and delivery of health care. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of health care. Medical Care provides timely reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services. In addition, numerous special supplementary issues that focus on specialized topics are produced with each volume. Medical Care is the official journal of the Medical Care Section of the American Public Health Association

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.

Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

For more information about our products and organization, visit http://www.wolterskluwerhealth.com, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.

Wolters Kluwer Health

Related Heart Attack Articles:

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.
New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.
Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.
A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.
Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.
Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.
Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.
How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.
Heart attack patients taken directly to heart centers have better long-term survival
Heart attack patients taken directly to heart centers for lifesaving treatment have better long-term survival than those transferred from another hospital, reports a large observational study presented today at Acute Cardiovascular Care 2019, a European Society of Cardiology congress.
Among heart attack survivors, drug reduces chances of second heart attack or stroke
In a clinical trial involving 18,924 patients from 57 countries who had suffered a recent heart attack or threatened heart attack, researchers at the University of Colorado Anschutz Medical Campus and fellow scientists around the world have found that the cholesterol-lowering drug alirocumab reduced the chance of having additional heart problems or stroke.
More Heart Attack News and Heart Attack Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.