Incomplete Nursing Care and Racial Disparities in Hospitals

Incomplete Nursing Care and Racial Disparities in Hospitals

Elderly Black Heart Attack Patients More Likely To Be Readmitted

The inability of nurses to complete all aspects of necessary care because of inadequate staffing is associated with higher rates of hospital readmissions, particularly for older black patients, according to a new study led by the University of Pennsylvania Nursing School's Margo Brooks Carthon.

The investigation is the first to explore the connection between unmet nursing care and the different patterns of readmissions experienced by white and black heart attack patients.

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Margo Brooks Carthon, PhD, RN, FAAN, is an Assistant Professor at Penn's School of Nursing, a faculty member of its Center for Health Outcomes and Policy Research (CHOPR), and a Senior Fellow at the Leonard Davis Institute of Health Economics (LDI). 

Media pickup
The study results have been the subject of articles on media outlets including Becker's Hospital Review, FierceHealthcare, Cardiology Today, Science Codex,  News Medical, MedIndia, Science Daily Medical News Today, and EurekAlert!.

Brooks Carthon, PhD, RN, FAAN is an Assistant Professor of Family & Community Health at Penn's School of Nursing and a Senior Fellow at the Leonard Davis Institute of Health Economics (LDI). She is also a member of the core faculty of the Nursing School's Center for Health Outcomes and Policy Research (CHOPR).

253 hospitals
Published in the May edition of the journal, Medical Care, the new study analyzed data from more than 69,000 black and white acute myocardial infarction (AMI) patients in 253 hospitals in Pennsylvania, New Jersey and California.

It found that older black patients were 18% more likely than older whites to be readmitted within 30 days of their hospital discharge and those same patients were more likely to "be in hospitals where nursing care was often left undone." 

Patterns of missed care
"Our findings suggest that unmet nursing care varies widely across U.S. hospitals and that older blacks disproportionately receive care in settings where care is missed more often," Brooks Carthon said in a University press office interview.

The specific sorts of missed nursing care measured by the researchers included talking to and comforting patients, completing medical documentation and administering medications.

The missing care category researchers found most associated with AMI readmission disparities was the administration of medications. The patients weren't getting the proper drugs at the proper time.

Nursing  'time scarcity'
Brooks Carthon and her co-authors note, "Nurses play a critical role in the care of post-AMI patients and are responsible for the facilitation of a range of interventions, including health education, administration of new drug therapies and ensuring a clear management plan is sent to the general practitioner. Despite their role, nurses increasingly report an inability to complete all necessary care due to time scarcity."

LDI Fellow and Doctoral Fellow at CHOPR, Karen Lasater, PhD, MS, BSN, RN, was also a member of the research team.