SAN DIEGO--Nursing staff at Fox Chase Cancer Center are
investigating the factors that put cancer patients at risk for hospital
readmission, said Carolyn Weaver, RN, MSN, AOCN, a clinical nurse specialist
and patient education coordinator at the Center. Ms. Weaver explained the study
in her poster presentation during the 26th Annual Conference of the Oncology
Nursing Society (abstract 166).
"We were looking at the readmission rate of cancer patients into the
Center and asked if there might be ways to identify why one person is more
likely to be readmitted than another," she said. "Four clinical nurse
specialists and our director of nursing research decided to do a research
study. Basically, it’s a medical chart review to see if we could identify
The research team developed a readmission criteria record to document
potential risk factors, including age, marital status, financial status, cancer
diagnosis, the reason for the initial admission and the readmission, other
medical conditions, supports patients may have at home, difficulty with coping
or with pain, or other unresolved issues.
"Our goal is to collect 150 patients in 1 year," Ms. Weaver said.
"We’ve done a pilot study on 16 charts to achieve inter-rater
reliabilitythat means all of us are completing the form in the same wayand
we’ve made adjustments throughout that process."
The team began its data collection in March 2001 and expects to go through
July 2002. They are reviewing charts of patients readmitted within 7 days of
discharge and charts of patients not readmitted.
"We’ll be doing data analysis, such as Chi-square and Fisher’s
exact tests, and the Mann-Whitney test to see if we can find out which criteria
influenced one group to be readmitted and not the other," Ms. Weaver said.
With this information in hand, the team’s goal at the end of the process
is to see if, as advanced practice nurses, they can identify those patients who
will be at risk and intervene with planning and follow-up at discharge,
ultimately reducing the readmission rate through care.