March 3, 2016

Nurse staffing, work environment linked to readmissions after total joints

By: Judy Mathias

Editor’s Note

Readmissions after total hip and knee replacements are associated with nurse staffing levels and poor nurse work environments, finds this study from the University of Pennsylvania School of Nursing, Philadelphia. The study analyzed data on more than 112,000 Medicare patients in nearly 500 hospitals.

Adjusting for patient and hospital characteristics, patients had 8% higher odds of 30-day readmission and 12% higher odds of 10-day readmission, for each additional patient in a nurse’s workload.

Patients who had surgery in hospitals where nurses reported having supportive environments, including strong collegial relationships with physicians and autonomy in clinical practice, were 12% less likely to be readmitted within 30 days.


Objective To examine the effect of nurse staffing and the work environment on 10- and 30-day unplanned readmissions for US Medicare patients following elective total hip and knee replacement. Design A cross-sectional analysis of secondary data. Setting Acute care hospitals in California, Florida, New Jersey and Pennsylvania, during 2006.


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