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Objectives: This study investigates risk of mortality associated with nurses’ assessments of patients by physiological system. We hypothesise that nursing assessments of in-patients performed at entry correlate with in-hospital mortality, and those performed just before discharge correlate with postdischarge mortality. Design: Cohort study of in-hospital and postdischarge mortality of patients over two 1-year periods. Setting: An 805-bed community hospital in Sarasota, Florida, USA. Subjects: 42 302 inpatients admitted for any reason, excluding obstetrics, paediatric and psychiatric patients. Outcome measures: All-cause mortalities and mortality OR. Results: Patients whose entry nursing assessments, other than pain, did not meet minimum standards had significantly higher in-hospital mortality than patients meeting minimums; and final nursing assessments before discharge had large OR for postdischarge mortality. In-hospital mortality OR were found to be: food, 7.0; neurological, 9.4; musculoskeletal, 6.9; safety, 5.6; psychosocial, 6.7; respiratory, 8.1; skin, 5.2; genitourinary, 3.0; gastrointestinal, 2.3; peripheralvascular, 3.9; cardiac, 2.8; and pain, 1.1. CI at 95% are within ±20% of these values, with p |
