For patients with Alzheimer's disease and dementia who seek treatment at hospitals that employ a greater number of nurses with at least a college degree, mortality rates may be lower after surgical procedures, according to a study published in Journal of the American Geriatrics Society.
The researchers looked at data on surgical patients 65 and older insured by Medicare who underwent general surgery, orthopedic procedures or vascular operations at 531 acute care hospitals across four states. The study included more than 46,000 patients with Alzheimer's or dementia and a control group of 307,000-plus patients who did not have these conditions.
The study revealed patients had a better chance of survival after surgery at hospitals where a larger percentage of nurses had at least four-year college degrees, even for surgical patients who a higher risk of complications or death.
Overall, 12,369 patients (3.5 percent) died within 30 days of admission to the hospital. The mortality rates were much higher (8 percent) for dementia patients, compared to less than 3 percent for patients without dementia.
Although the proportion ranged from zero to 74 percent, roughly 38 percent of nurses had at least a four-year bachelor's degree on average. The study found larger hospitals, teaching hospitals and high-technology facilities tended to have more college-educated nurses.
After accounting for the type of surgery as well as the characteristics of individual hospitals and patients, the researchers found each 10 percent increase in the proportion of nurses with at least a bachelor's degree connected to a 10 percent lower chance of death for patients with dementia and a 4 percent lower chance of death for patients without dementia.
"This suggests that comprehensive nursing care plays an important role in reducing some of the excess risk patients with dementia face when undergoing surgery, and that better education helps nurses manage the higher complexity of this patient population," lead study author Elizabeth White, BSN, MSN, told Reuters.
"As the population ages, hospitals will be faced with the challenges of caring for an increasing number of frail, cognitively impaired older adults," Ms. White said. "Our findings suggest that transitioning to a largely [college-educated] nursing workforce, as the Institute of Medicine recommends, would contribute to improved surgical outcomes for this population."