Early post-discharge nursing care ‘improves’ sepsis outcomes

The researchers highlighted that sepsis survivors accounted for the majority of readmissions across the country and that effective interventions were needed to decrease these poor outcomes.

“Both together reduced the probability of 30-day all-cause readmission by seven percentage points”

Study authors

They warned that there was “little evidence to guide the care” of sepsis survivors following hospital discharge despite high rates of readmission.

Their study found a combination of early home nursing and at least one outpatient visit in the first week after discharge was more effective than either intervention alone for cutting readmission.

The national study was carried out by the Center for Home Care Policy and Research at the Visiting Nurse Service of New York, in collaboration with the University of Pennsylvania School of Nursing.

The study involved 170,571 mostly older adults with severe sepsis and a multitude of comorbid conditions and functional limitations.

They examined the impact of early home nursing, with a first visit within two days of hospital discharge and at least one additional visit in the first post-discharge week, and early physician follow-up, with an outpatient visit in the first post-discharge week.

They compared the effect of both treatment protocols alone, in combination and against normal care on reducing 30-day readmissions among sepsis survivors.

University of Pennsylvania School of Nursing

Kathryn Bowles

Source: Penn Nursing

Dr Kathryn Bowles

Among the participants, 44.7% received only the nursing protocol, 11% only the medical doctor protocol, 28.1% both protocols, and 16.2% neither.

The study authors concluded that the combination of home nursing visits and early physician follow-up led to a co-ordinated care plan and early surveillance for new or recurrent problems.

“Although neither protocol by itself had a statistically significant effect on readmission, both together reduced the probability of 30-day all-cause readmission by seven percentage points,” they said.

Study co-principal investigator and nurse Dr Kathryn Bowles said: “Our findings support integrated care management, including scheduling physician follow-up before discharge rather than recommending that patients schedule their own follow-up.”

She said that, if “translated” more widely, the intervention could help improve outcomes for sepsis survivors.

The study, published in the journal Medical Care, was supported by funding from the US National Institute of Nursing Research of the National Institutes of Health.