Nurse work environment influences stroke outcomes

Stroke remains a leading cause of death worldwide and one of the most common reasons for disability. While a wide variety of factors influence stroke outcomes, data show that avoiding readmissions and long lengths of stay among ischemic stroke patients has benefits for patients and health care systems alike. Although reduced readmission rates among various medical patients have been associated with better nurse work environments, it is unknown how the work environment might influence readmissions and length of stay for ischemic stroke patients.

In a new study from the University of Pennsylvania School of Nursing's (Penn Nursing) Center for Health Outcomes and Policy Research (CHOPR), researchers evaluated the association between the nurse work environment and readmission and length of stay for close to 200,000 hospitalized adult ischemic stroke patients in more than 500 hospitals. They found that in hospitals with better nurse work environments, ischemic stroke patients experienced lower odds of 7- and 30-day readmissions and lower lengths of stay.

Their research has been published in the journal Research in Nursing & Health. The article "Better Nurse Work Environments Associated with Fewer Readmissions and Shorter Length of Stay Among Adults with Ischemic Stroke: A Cross-Sectional Analysis of United States Hospitals" is available online.

"The work environment is a modifiable feature of hospitals that should be considered when providing comprehensive stroke care and improving post-stroke outcomes," says Heather Brom, Ph.D., RN, NP-C, lecturer at Penn Nursing and lead author of the article. "Our findings have important implications for quality improvement initiatives for stroke care management."

Creating good work environments for nurses is especially important so that they have adequate time to spend with stroke patients and can communicate effectively with all team members and feel supported by managers to make decisions about nursing care. "All of these aspects of the nurse work environment facilitate an effective and efficient discharge planning process, which has the potential to decrease delays in discharge and avoidable readmissions," says J. Margo Brooks Carthon, Ph.D., RN, FAAN, Associate Professor of Nursing and one of the co-authors of the article.