Addressing the economic and human cost of hospital acquired and nurse-sensitive adverse events in older patients through optimal use of routine discharge data and measurement of missed nursing care

Older patients make up the largest patient group in acute hospitals in Ireland. Common hospital acquired complications in this group contribute to higher healthcare costs, lower quality care, and less satisfactory patient experiences overall. Pneumonia, delirium, urinary tract infections and pressure injuries are four commonly acquired complications which occur in older patients, known collectively as ‘Failure to Maintain (F2M)’ events. These are ‘nurse-sensitive’ complications, which means they are primarily affected by the level of nursing care provided, and therefore can be impacted by the numbers of nurses on duty and how busy those nurses are. Sometimes due to staff shortages or high workloads, some important nursing work is missed or left undone at the end of a shift. Some patients do not therefore receive all the care they need, and may go on to develop complications.

In Ireland, data are collected on each patient discharge from acute hospitals, and used to calculate costs and examine trends. This routinely collected data commonly focus on medical information rather than nursing information. We propose that information on nurse- sensitive complications should be routinely collected in this way also, and will pilot this so that so that nursing care can be made more visible and trends can be addressed, costs calculated.

In this study we intend to examine how often ‘nurse-sensitive’ complications occur to older patients in Irish hospitals, and the associated cost to the health service. Furthermore, through both nurse and patient surveys, we intend to examine the human cost of missed nursing care that is missed, what types of care are missed and in what circumstances. We intend to shed light on the consequences of missed nursing care for older patients and propose a sustainable approach to measuring, monitoring and addressing this contemporary challenge to patient safety in Irish hospitals.

Award Date
01 July 2022
Award Value
Principal Investigator
Dr Marcia Kirwan
Host Institution
Dublin City University
Investigator Led Projects