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Nursing Research and Practice
Volume 2012, Article ID 350830, 14 pages
Research Article

Multidisciplinary Treatments, Patient Characteristics, Context of Care, and Adverse Incidents in Older, Hospitalized Adults

1Nursing Research, Quality, and Innovation, University of Michigan Health System, 300 North Ingalls, Room NI 5A07, Ann Arbor, MI 48109-5446, USA
2University of Michigan School of Nursing and University of Michigan Health System, 400 North Ingalls, Suite 4170, Ann Arbor, MI 48109-5482, USA

Received 29 September 2011; Revised 3 December 2011; Accepted 3 December 2011

Academic Editor: John Daly

Copyright © 2012 Leah L. Shever and Marita G. Titler. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The purpose of this study was to examine factors that contribute to adverse incidents by creating a model that included patient characteristics, clinical conditions, nursing unit context of care variables, medical treatments, pharmaceutical treatments, and nursing treatments. Data were abstracted from electronic, administrative, and clinical data repositories. The sample included older adults hospitalized during a four-year period at one, academic medical facility in the Midwestern United States who were at risk for falling. Relational databases were built and a multistep, statistical model building analytic process was used. Total registered nurse (RN) hours per patient day (HPPD) and HPPDs dropping below the nursing unit average were significant explanatory variables for experiencing an adverse incident. The number of medical and pharmaceutical treatments that a patient received during hospitalization as well as many specific nursing treatments (e.g., restraint use, neurological monitoring) were also contributors to experiencing an adverse incident.