This study examined the nurse-associated factors that may contribute to 30-day readmission rates on medical-surgical nursing units. Finding solutions to decrease readmission rates is vital for healthcare organizations, so exploring factors like nurse staffing and assignments may be a possible solution.

The researchers looked at 18,203 adult medical-surgical patients at 31 Magnet hospitals in the United States.

The hospitals included in this study were all Magnet facilities like Houston Methodist Hospital; however, not all hospitals were large academic medical centers like ours.

The investigators used a data set from the Readiness Evaluation and Discharge Interventions (READI) clinical trial. They used correlational statistics to analyze nursing continuity, patient outcomes, unit environment characteristics, unit nursing characteristics, and patient characteristics to determine which factors impacted 30-day readmissions the most. This is an appropriate methodology for this non-interventional study.

The researchers found that . Additionally, the higher percentage of BSN-prepared nurses on the unit, even for units who had more complex patients, had the most significant decrease in 30-day readmissions and fewer emergency department or observations visits post-discharge.

Their primary results do make sense. However, some of their secondary outcomes seem counterintuitive. For example, they found that patient readiness for discharge was not a factor in reducing 30-day readmission. One limitation of this study was that they did not discuss the involvement of additional discharge support personnel, such as case managers, social workers, and their participation in discharge. They should have included how those healthcare providers contribute to the discharge process.

This was a non-interventional study that used retrospective data, so nothing changed during the study. But their findings have great potential to positively impact how nursing assignments are made, particularly around the time of patient discharges.

Many protocols and process improvement projects revolve around reducing 30-day readmissions. This article proposes that nursing continuity, particularly in the days leading up to discharge, should be considered. Additionally, the concept of nursing continuity may be useful when applied to patients transitioning to a different level of care. This was not included in this study but might be an opportunity for further research. Lastly, they found that having more BSN-prepared nurses on a unit seems to impact 30-day readmission rates. This factor supports the Magnet and HMH goal of having a high percentage of BSN prepared nurses.