Nursing Home Complications Following Hospitalization May Be Prevented With Better Coordination: Study

New research suggests that nearly half of patients transitioning from hospitals to long term nursing home care facilities suffer mild to severe injuries, many of which could have been prevented if better coordination and patient information sharing systems were in place.

On July 22, University of Massachusetts researchers published a study in JAMA Internal Medicine, which examines the frequency and severity of injuries suffered by patients transitioning from a hospital to a nursing home facility.

Approximately four out of 10 patients suffered a preventable injury, according to the findings, which highlight the need to better communicate information during and after a hospital transition to a nursing home.

Researchers set out to determine the prevalence and severity of patient nursing home complications after moves between care facilities, and if any apparent factors caused injuries. Study participants consisted of 555 patients who were discharged from a hospital to one of 32 randomly selected New England long-term-care facilities from March 1, 2016 through December 31, 2017, and followed up for injury reports for the first 45 days from the transition.

Of the 555 patients, researchers discovered a total of 379 adverse events among 762 hospital-to-long term care facility discharges. Of the 379 adverse events, the majority were classified as preventable.

Researchers found 197 events involved resident care related injuries such as pressure ulcers or bedsores, skin tears, and nursing home falls resulting in hospital treatment. This category represented 52% of all recorded events, while health-care acquired infections represented 28.5% of injuries.

Of the 197 resident care related injuries recorded, 173 were categorized as preventable, suggesting that with the appropriate level of care and attention, the injuries may not have occurred. Approximately 60% of all adverse drug events and 35% of all healthcare acquired infections were deemed preventable.

Of the adverse events, 145 were deemed serious and nearly 8% were considered life-threatening, which included events such as sepsis or opioid overdose. The records indicated just over 2% of all complications resulted in fatalities, while another 3.7% resulted in permanent disability.

Researchers concluded that four out of ten patient discharged from hospitals back to long term care facilities resulted in a preventable adverse events, with many of the injuries occurring within the first seven days of arriving at the nursing home.

With more than 70% of all recorded injuries being classified as preventable, researchers determined the transition of patients from hospitals to long-term care facilities requires a standardized reporting of events and better coordination and information transfer across settings, to prevent adverse event and better inform care facilities of patient limitations and medical needs.

Earlier this year, the Department of Health and Human Services’ Office of the Inspector General (OIG) released a nursing home abuse report, indicating that many skilled nursing homes fail to report injuries sustained by the residents in accordance with Federal requirements, highlighting 37,607 high-risk hospital and emergency room claims for Medicare beneficiaries were reported in 2016.

The data revealed 2,574 incidents allegedly perpetrated by a healthcare worker, 3,330 related to incidents occurring at a medical facility and 9,294 incidents not reported to local law enforcement.