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Nurse Work Environment Tied to Ischemic Stroke Outcomes

TUESDAY, April 13, 2021 -- In hospitals with better nurse work environments, ischemic stroke patients experience lower odds of readmissions and shorter lengths of stay, according to a study published online March 2 in Research in Nursing & Health.

Heather Brom, Ph.D., R.N., from the M. Louise Fitzpatrick College of Nursing at Villanova University in Pennsylvania, and colleagues linked data sources (543 hospitals) to evaluate the association between the nurse work environment and readmissions and length of stay for 175,467 hospitalized adult ischemic stroke patients. The nurse work environment was derived from responses to the RN4CAST-US using the validated and reliable practice environment scale of the nursing work index.

The researchers found that seven- and 30-day readmission rates were 3.9 and 10.1 percent, respectively, and the average length of stay was 4.9 days. Ischemic stroke patients experienced lower odds of both seven- and 30-day readmission (seven-day: odds ratio, 0.96; 30-day: odds ratio, 0.97) and reduced length of stay (incident rate ratio, 0.97) in hospitals with better nurse work environments.

"The work environment is a modifiable feature of hospitals that should be considered when providing comprehensive stroke care and improving poststroke outcomes," Brom said in a statement. "Our findings have important implications for quality improvement initiatives for stroke care management."

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