University of Pennsylvania School of Nursing

Newly Announced CDC Guidelines Aim to Reduce Avoidable Rehospitalizations NEW YORK, Sept. 30, 2024 /PRNewswire/ -- Taking effect October 1, the Centers for Disease Control and Prevention (CDC) is adding an important new diagnostic code to their annual update of the International Classification of Diseases (ICD-10) list. The new "Encounter for Sepsis Aftercare" update came about as the result of ground-breaking research from the Center for Home Care Policy & Research at VNS Health and the University of Pennsylvania School of Nursing (Penn Nursing). The new code, z51A, supports providers in hospitals and health facilities nationwide by alerting home care clinicians and other post-acute care providers when a patient is being discharged to aftercare following hospitalization for sepsis, a life-threatening medical condition triggered by an extreme response to infection. Continue Reading Kathryn H. Bowles, PhD, RN, Director of the VNS Health Center for Home Care Policy & Research; Professor and van Ameringen Chair in Nursing Excellence at Penn Nursing The need for a new ICD-10 code for sepsis survivors was spurred by findings from a VNS Health study where analysis of the records of over 165,000 sepsis survivors entering home care showed that sepsis was noted in admission assessments only 7% of the time. This alarming discovery caused the researchers to question whether home health providers were even aware that a patient had been diagnosed with sepsis. This study also identified risk factors associated with early readmission of sepsis survivors. The study, led by Kathryn H. Bowles, PhD, RN, Director of the VNS Health Center for Home Care Policy & Research; Professor and van Ameringen Chair in Nursing Excellence at Penn Nursing, was published in the Journal of the American Medical Directors Association, in 2020. "Our work has shown that timely attention by home care and outpatient clinicians is highly effective for sepsis survivors. It is critically important to communicate sepsis survivorship across transitions in care because among those readmitted from home health care, one-third occur in the first seven days," said Dr. Bowles. "We are hopeful this new ICD code will direct the necessary attention to sepsis survivors and improve outcomes for the 1.7 million Americans who encounter sepsis each year." In an ongoing NIH funded study (R01NR016014) also led by Dr. Bowles with VNS Health colleagues, interviews with personnel at 16 hospitals and five affiliated home health agencies across the U.S. revealed the lack of a diagnostic code to identify sepsis survivors after discharge. Home health personnel explained that because sepsis is an acute care condition treated and resolved in the hospital, they are not able to place it on the home care record. The study provided evidence that because of this communication gap, home care providers and clinicians may not be prompted to provide the timely attention and close monitoring that sepsis recovery warrants. Between one-third and one-half of readmissions are due to sepsis recurrence and up to 50% of sepsis survivors are left with long-term physical and/or psychological effects. It is critical that post-acute care clinicians are aware they are caring for a sepsis survivor. Following publication of these research findings, Dr. Bowles and her team led a coordinated advocacy effort aimed at persuading the CDC of the need for a diagnostic code that defines sepsis aftercare as a separate condition. After a formal presentation by the team to a CDC committee in March of 2023, a new ICD-10 code was accepted and announced in July of this year. The code takes effect October 1, 2024. About VNS Health and the Center for Home Care Policy & Research : VNS Health is one of the nation's largest nonprofit home- and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us—we help people live, age, and heal where they feel most comfortable, in their own homes, connected to their family and community. The organization offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of those we serve in New York and beyond. These include The Center for Home Care Policy & Research, which for over 30 years has been advancing the national knowledge base underpinning home- and community-based services by conducting scientifically rigorous research and supporting informed decision-making by providers, policymakers, and consumers. SOURCE VNS Health WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

MONDAY, June 24, 2024 -- Older patients with COVID-19 are more likely to survive hospitalization in facilities with adequate nursing resources, according to a study published online June 7 in the International Journal of Nursing Studies . Karen B. Lasater, Ph.D., R.N., from the University of Pennsylvania School of Nursing in Philadelphia, and colleagues evaluated whether hospital differences in prepandemic and during pandemic nursing resources (e.g., average patient-to-registered nurse [RN] staffing ratios, proportion of bachelors-qualified RNs, nurse work environments, and Magnet recognition) explain differences in risk-adjusted COVID-19 mortality. Analysis included 87,936 Medicare beneficiaries (65 to 99 years old) hospitalized with COVID-19 and discharged (or died) between April 1 and Dec. 31, 2020, from 237 general acute care hospitals in New York and Illinois. The researchers found that 23 percent of admitted patients died during the hospitalization, and 31.5 percent died within 30 days of admission. Risk of death was significantly lower for patients admitted with COVID-19 to hospitals with better nursing resources prepandemic and during the pandemic. Each additional patient in the average nurses' workload prepandemic was associated with significantly higher odds of in-hospital mortality (odds ratio, 1.20) and of 30-day mortality (odds ratio, 1.15). Similar protective effects were seen for hospitals with greater proportions of bachelors-qualified RNs, better quality nurse work environments, and Magnet recognition. "If all hospitals in the study had superior nursing resources prior to or during the pandemic, models estimate many thousands of deaths among patients hospitalized with COVID-19 could have been avoided," the authors write. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

The risk of a COVID-19 patient's in-hospital mortality rose by 20% for each additional patient added to a nurse's workload in the months before the pandemic, a recently published study found. Its lead author said the data help make the case for state and federal hospital nurse staffing regulations. COVID-19 patients admitted to hospitals with fewer nursing resources prior to and during the early pandemic were significantly less likely to survive their illness, a recent study found. Among nearly 88,000 Medicare patients discharged from 237 hospitals with COVID-19 between April and December 2020, nearly a quarter died during their hospitalization and almost a third died within the 30 days following their admission, researchers from the University of Pennsylvania wrote in the International Journal of Nursing Studies. The rates were worse among the hospitals with reduced nurse staffing, according to the study. For example, a COVID-19 patient’s odds of in-hospital mortality rose by 20% for each additional patient a registered nurse had in their workload in the months just before the pandemic began (December 2019 to February 2020). Odds of 30-day mortality rose by 15% under the same circumstances. The general trend extended to the hospitals that—either before or during the study period—had a lower proportion of registered nurses with a bachelor of science in nursing, did not have a Magnet recognition and had worse scores on a nurse-reported survey on the quality of their work environment. “These findings demonstrate that hospital nursing resources are a cornerstone of public health emergency-preparedness that need to be well-funded in usual times in order for hospitals to be prepared for emergencies like the next pandemic,” Linda Aiken, Ph.D., senior author, professor of nursing and founding director of the University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research, said in a release. The team’s study included hospitals in New York and Illinois. Its average patient was 78 years old. Among these, researchers saw the highest rates of mortality in April 2020, a dip during the summer and then a steady rise through the end of the year. The team’s analysis also included models estimating “many thousands” of deaths could have been avoided with “superior nursing resources” both before and during the pandemic. Specifically, they wrote that a uniform registered nurse-to-patient ratio of 4:1 would have reduced in-hospital mortality among the sample by 17%, or nearly 3,500 deaths. The researchers said their work is among the few studies that have answered why COVID-19 mortality rates varied between hospitals during the pandemic. “Modifiable aspects” of a hospital’s workforce investments like these “are linked to more favorable patient outcomes during ordinary times and also represent important emergency-preparedness dashboard metrics that should be required in emergency preparedness plans,” they wrote. Karen Lasater, Ph.D., the study’s lead author and an associate professor at the nursing school, said the findings and other nurse staffing and outcomes research from her and Aiken make the case for government intervention. “It is in the public’s interest to establish state and federal policies that guarantee a minimum safe standard of hospital nurse staffing at all times,” Lasater said in a release. “Our team’s work shows that U.S. hospitals were already chronically understaffed prior to the pandemic and staffing worsened during the pandemic.”