Summary of Two Articles

1: Quantitative Study

Hospital Readmission Performance and Patterns of Readmission: Retrospective Cohort Study of Medicare Admissions

Problem Statement

The problem that is addressed by Dharmarajan, Hsieh, Lin et al. (2013) in their quantitative study is that too little is known regarding the relationship between hospital rates of readmission and the diagnoses and timing of readmissions. By better understanding this relationship, the researchers hypothesize that more effective approaches to lower readmission rates may be deduced.

Statement of Purpose

The researchers identify their objective within the study in the following terms: To determine whether high performing hospitals with low 30 day risk standardized readmission rates have a lower proportion of readmissions from specific diagnoses and time periods after admission or instead have a similar distribution of readmission diagnoses and timing to lower performing institutions (Dharmaraian et al., 2013, p. 1).

Research Question(s)/Hypothesis

The research questions that the researchers pose are two-fold: 1) Does the spectrum of readmission diagnoses and median time to readmission varied by categorization of performance and, if so, 2) do they varied for better and worse performers in a consistent manner for all three conditions?

The hypothesis for that study was that high performing hospitals with the lowest 30 day readmission rates would have proportionately fewer readmissions across all diagnoses and time periods after discharge.

Study Methods

A retrospective cohort study was used to answer the research questions. Participants were patients aged 65 and older who had been readmitted within one month of hospital admission for heart failure, acute myocardial infarction or pneumonia between the years of 2007 and 2009. Categorization of readmission diagnoses and timing was done by using the Centers for Medicare and Medicaid Services condition categories.

Key Findings

In the one month following the initial admission, the researchers found that hospitals with varying 30...…2010 to April 2011 (Tzeng et al., 2012, p. 272). Interviews were conducted in 2011. 18 RNs and 13 PCAs were interviewed for the study. Themes were developed from patients responses to determine whether nurses had demonstrated awareness of proper bed height for patients by communicating the best setting level to the patient.

Key Findings

The study found that nurse awareness of the need to keep bed settings at the lowest level to prevent patient falls was mixed and a solid conclusion was limited by the researchers use of pre-existing data, which was analyzed to find themes. The interview responses showed that there is a limited amount of awareness among nurses as to the importance of this subject and that most nurses are focused on other patient-related issues and their own workload more than they are on communicating the need to keep the patients bed at the lowest…