ICNP nursing diagnoses associated to elderly patients’ hospital 30-days readmission: an observational longitudinal study

Introduction. The international literature widely agrees that one of the most serious problems of health services is elderly patients readmission, usually 30 days after their discharge. While many studies identified disease variables related to readmission, only few studies investigated the relationship between nursing-related variables and readmission. Aim. To identify the association between nursing care needs at the discharge of elderly patients and hospital readmissions at 30 days. Methods. An observational longitudinal study was conducted enrolling a sample of 148 patients aged over 65. Nursing needs were identified by and Italian theoretical model and the International Classification for Nursing Practice. Data were collected by medical records. Linear correlations and logistic regression models were performed. Results. Readmission at 30 days was 19.6%. Nursing needs of Safe environment (p = 0.04) and Communication (p = 0.06) were significantly associated to 30-days readmission. Furthermore, an higher risk for readmission was found for those patients who had at least one of the following ICNP nursing diagnoses: Impaired psychomotor activity, Aggressive behaviors, Chronic confusion, Risk for confusion, Risk for delirium and Agitation (p = 0.009). Conclusions. The need for nursing care as well as some specific ICNP nursing diagnoses represent significant risk factors for the readmission of elderly patients. These needs and diagnoses should be systematically evaluated to plan patients discharge. Further studies are needed to evaluate on a larger international sample ICNP nursing diagnoses associated to 30-days readmission of hospitalized older people