Abstract
Background: In-hospital mortality is a key indicator of the quality of care. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. Currently, new variables, such as nursing workload or the level of dependency, are being incorporated. We aimed to identify which individual, clinical and hospital characteristics are related to hospital mortality. Methods: A multicentre prospective observational study design was used. Sampling was conducted between February 2015 and October 2017. Patients over 16 years, admitted to medical or surgical units at 11 public hospitals in Andalusia (Spain), with a foreseeable stay of at least 48 h were included. Multivariate regression analyses were performed to analyse the data. Results: The sample consisted of 3821 assessments conducted in 1004 patients. The mean profile was that of a male (52%), mean age of 64.5 years old, admitted to a medical unit (56.5%), with an informal caregiver (60%). In-hospital mortality was 4%. The INICIARE (Inventario del Nivel de Cuidados Mediante Indicadores de Clasificación de Resultados de Enfermería) scale yielded an adjusted odds ratio [AOR] of 0.987 (95% confidence interval [CI]: 0.97–0.99) and the nurse staffing level (NSL) yielded an AOR of 1.197 (95% CI: 1.02–1.4). Conclusion: Nursing care dependency measured by INICIARE and nurse staffing level was associated with in-hospital mortality.
Highlights
The International Classification for Patient Safety defined an adverse event (AE) as any healthcare-related incident that causes harm to patients [1]
Nursing care dependency measured by INICIARE and nurse staffing level was associated with in-hospital mortality
Most of the patients were admitted to medical units (56.3%)
Summary
The International Classification for Patient Safety defined an adverse event (AE) as any healthcare-related incident that causes harm to patients [1]. The prevalence of in-hospital AEs in the European Union ranges from 8% to 12%, where 1 in every 100,000 inhabitants dies from this cause, i.e., about 5000 deaths per year [2,3]. The latest report by the Ibero-American Study of Adverse Events (IBEAS) established a prevalence of AEs of 10.5% and a cumulative incidence close to 20% [4]. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. New variables, such as nursing workload or the level of dependency, are being incorporated. Patients over 16 years, admitted to medical or surgical units at 11 public hospitals in Andalusia (Spain), with a foreseeable stay of at least 48 h were included.
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