Continuity Index Measures in the Acute Care Hospital Setting: An Analytic Review and Tests Using Electronic Health Record Data and Computer Simulation

Association between continuity of nursing care and older adults' hospitalization outcomes: A retrospective observational study

AIM

To assess the relationship between continuity in nursing assignment in older adults' acute hospitalization and patient experience and functional decline.

BACKGROUND

In-hospital functional decline affects up to 40% of hospitalized older adults. Nurses are responsible for performing functioning-preserving interventions. Whether continuity of nursing care contributes to patients' functional outcomes is unclear.

METHOD

A retrospective observational study of 609 patients aged ≥70 admitted to internal medicine units. Patients were surveyed on their functional (cognitive and physical) status and satisfaction with the hospital care experience. Dispersion and sequence of nursing assignment were measured by the Continuity of Care Index and Sequential Continuity Index. Multivariate logistic regressions were modelled for each continuity score and outcome.

RESULTS

Achieving 25% of the maximum Continuity of Care Index was associated with lower odds of cognitive decline (OR = 0.64, 95% CI = 0.43-0.94) and higher odds of satisfaction (OR = 1.52, 95% CI = 1.06-2.17). Achieving 25% of the maximum Sequential Continuity Index was associated only with higher odds of satisfaction (OR = 1.43, 95% CI = 1.01-2.02). Continuity scores were not associated with physical functioning decline.

CONCLUSION

Continuity in nursing assignment is related to a positive patient experience and cognitive functioning of hospitalized older adults.

IMPLICATIONS FOR NURSING MANAGEMENT

Continuity should be prioritized in scheduling and assignment algorithms.