Research Article

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

Table 2

Results from the model building process for determining explanatory variables of experiencing an adverse incident.

VariableSignificant values for within block correlationsSignificant values for the final model

Patient characteristics
Ethnicity0.0029
Site admitted from<0.0001

Clinical conditions
Primary medical diagnoses (% of sample)
 Cancer, other primary (1.7)<0.00010.0010
 Maintenance chemotherapy, radiotherapy (1.1)0.1408
 Fluid and electrolyte disorder (1.6)0.0172
 Senility & organic mental disorders (3.0)<0.00010.0140
 Affective (2.1)0.0007
 Other nervous system disorders (1.1)0.06860.0176
 Respiratory (3.1)0.0687
 Chronic obstructive pulmonary (1.8)0.0332
 Symptoms, signs, and ill-defined conditions (1.8)0.1034
 Severity of illness<0.0001
 Congestive heart failure (11.8)0.0155
 Other neurological disorders (3.6)0.1218
 Diabetes (17.7)0.0347
 Peptic ulcer disease without bleeding (4.4)0.0985
 Rheumatoid arthritis/collagen vas (4.0)0.0918
 Psychoses (5.7)0.0211
 Depression (6.6)0.0237

Severity of illness
 Severity of illness<0.0001

Elixhauser comorbid conditions (% of sample)
Congestive heart failure (11.8)0.0155
Other neurological disorders (3.6)0.1218
Diabetes (17.7)0.0347
Peptic ulcer disease without bleeding (4.4)0.0985
Rheumatoid arthritis/collagen vas (4.0)0.0918
Psychoses (5.7)0.0211
Depression (6.6)0.0237

Past hospitalizations
 Past hospitalizations0.0199

Context of care variables
Number of units resided on<0.0001
CGPR dip proportion<0.00010.0092
Skill mix0.0003
Average caregiver patient ratio<0.0001<0.0001

Treatments
Medical treatments
 Total number of procedures<0.00010.0059
Types of medical treatments (% of sample)
 Incision and excision of CNS (2.0)0.0059
 Incision of pleura, thoracentesis, chest drainage (3.8)0.0637
 Coronary artery bypass graft (CABG) (3.1)<0.0001
 Diagnostic cardiac catheterization, coronary arteriography (7.9)0.0007
 Other therapeutic procedures, hemic and lymphatic system (2.8)0.1205
 Upper gastrointestinal endoscopy, biopsy (6.6)0.0062
 Gastrostomy, temporary and permanent (1.5)0.1035
 Oophorectomy, unilateral & bilateral (1.3)0.0062
 Partial excision bone (1.5)0.0769
 Treatment of fracture or dislocation (2.3)0.0513
 Arthroplasty (3.0)0.0014
 Amputation of lower extremity (1.1)0.1257
 Spinal fusion (1.0)0.0089
 Debridement of wound, infection or burn (1.5)0.0395
 Arterio or venogram (not heart or head) (2.2)0.0091
 Diagnostic ultrasound (33.5)0.0048
 Radioisotope scan (6.6)0.0667
 Physical therapy (4.7)<0.00010.0015
 Psychological and psychiatric evaluation and therapy (1.8)<0.0001
 Enteral and parenteral nutrition (9.5)0.0063

Pharmaceutical treatments
 Number of unique medications<0.0001<0.0001

Types of pharmaceutical treatments (% of sample)
 Sympathomimetic (adrenergic) agents (17.3)0.0241
 Anticholinergic agents (13.5)0.0054
 Skeletal muscle relaxants (5.4)0.0140
 Cardiac drugs (64.8)0.0445
 Hypotensive agents (37.7)0.0882
 Psychotherapeutic agents (35.0)<0.0001
 Succinimides (27.8)<0.00010.0015
 Miscellaneous central nervous system agents (3.9)0.0923
 Opiate antagonists (1.4)0.0669
 Anorexigenic agents and respiratory & cerebral stimulants (1.4)0.0146
 Caloric agents (51.8)0.02440.0128
 Irrigating solutions (7.3)0.0414
 Ammonia detoxicants (2.7)0.07850.0274
 EENT anti-infectives (42.2)0.00020.0148
 EENT carbonic anhydrase inhibitors (2.2)0.0404
 Miscellaneous GI drugs (59.8)0.1098
 Parathyroid (1.4)0.0228
 Anti-infectives (21.5)0.0346
 Anti-inflammatory agents (6.8)0.0438
 Multivitamin preparations (18.7)0.0425
 Vitamin B complex (7.4)0.1130
 Unclassified therapeutic agents (34.0)0.0619
 Tetracyclines (1.3)0.1135
 Opiate agonists (64.0)0.0034
 Barbiturates (2.8)0.0014
 Benzodiazepines (56.2)0.0024
 Misc. anxiolytics, sedatives, & hypnotics (17.8)0.0022

Nursing treatments
Nursing treatment types (% of sample)
 Fluid management (99.5)0.0098
 Bathing (93.5)0.0600
 Pressure ulcer care (91.5)<0.00010.0005
 Bowel management (88.2)0.1049
 Teaching (81.5)0.0003
 Discharge planning (76.0)0.0042
 Routine care: adult (56.2)0.0626
 Health screening (48.8)<0.0001<0.0001
 Sleep enhancement (47.7)0.0572
 Oxygen therapy (42.4)0.0008
 Post-op care (27.8)<0.0001
 Wound care (21.4)0.0137
 Neurologic monitoring (20.2)0.00020.0003
 Analgesic administration (17.2)0.0723
 Fluid/electrolyte monitoring (15.1)0.0365
 Medication management (12.2)0.0678
 Nutrition management (11.3)0.0022
 Embolus precautions (9.4)0.0687
 Infection protection (8.9)0.0182
 Enteral tube feeding (9.4)0.0042
 Blood products administration (8.6)0.00040.0192
 Restraint (8.5)<0.0001<0.0001
 Postprocedure care (5.6)0.0219
 Specimen management (5.3)0.00790.0098
 Active listening (4.8)0.01610.0003
 Surgical preparation (4.1)0.12810.0441
 Total parenteral nutrition (TPN) administration: adult (3.4)0.0033
 Aspiration precautions (3.2)0.0233
 Anger control assistance (2.8)0.0177
 Mood management (2.5)0.00910.0004
 Self-care assistance (2.2)0.1323
 Procedure preparation (2.1)0.1079
 Dementia management (1.6)0.0816
 Electroconvulsive therapy (1.6)0.0290
 Cast care: maintenance (1.1)0.00350.0037
 Splinting (1.1)0.0086
 Music therapy (1.1)0.00360.0019
 Medical immobilization (0.9)0.0356