Marianjoy Library

Online Nursing Journal Club

April, 2014

Welcome to the online Nursing Journal Club! The article for this month will count for 1.5 continuing education credits. Attached is the article in PDF format. This article will be available through April 30. Discussion Via Google Docs/Drive

Reading Assignment:



Predictors of Rehospitalization among Elderly Patients Admitted to a Rehabilitation Hospital: The Role of Polypharmacy, Functional Status, and Length of Stay
Morandi A1, Bellelli G, Vasilevskis EE, Turco R, Guerini F, Torpilliesi T, Speciale S, Emiliani V, Gentile S, Schnelle J, Trabucchi M.

J Am Med Dir Assoc. 2013 Oct;14(10):761-7. doi: 10.1016/j.jamda.2013.03.013. Epub 2013 May 7

Available Full-Text only from the Marianjoy network.




Rehospitalizations for elderly patients are an increasing health care burden. Nonetheless, we have limited information on unplanned rehospitalizations and the related risk factors in elderly patients admitted to in-hospital rehabilitation facilities after an acute hospitalization.


In-hospital rehabilitation and aged care unit

Retrospective cohort study.

Elderly patients 65 years or older admitted to an in-hospital rehabilitation hospital after an acute hospitalization between January 2004 and June 2011.

The rate of 30-day unplanned rehospitalization to hospitals was recorded. Risk factors for unplanned rehospitalization were evaluated at rehabilitation admission: age, comorbidity, serum albumin, number of drugs, decline in functional status, delirium, Mini Mental State Examination score, and length of stay in the acute hospital. A multivariable Cox proportional regression model was used to identify the effect of these risk factors for time to event within the 30-day follow-up.

Among 2735 patients, with a median age of 80 years (interquartile range 74-85), 98 (4%) were rehospitalized within 30 days. Independent predictors of 30-day unplanned rehospitalization were the use of 7 or more drugs (hazard ratio [HR], 3.94; 95% confidence interval, 1.62-9.54; P = .002) and a significant decline in functional status (56 points or more at the Barthel Index) compared with the month before hospital admission (HR 2.67, 95% CI: 1.35-5.27; P = .005). Additionally, a length of stay in the acute hospital of 13 days or more carried a twofold higher risk of rehospitalization (HR 2.67, 95% CI: 1.39-5.10); P = .003).
The rate of unplanned rehospitalization was low in this study. Polypharmacy, a significant worsening of functional status compared with the month before acute hospital admission, and hospital length of stay are important risk factors.
Copyright © 2013 American Medical Directors Association, Inc. All rights reserved.

The purpose of the online Nursing Journal Club is to facilitate the use of evidence-based practice in providing excellent nursing care.


  • Identify at least two factors that may contribute to rehospitalization of elderly patients
  • Identify at least two conditions commonly seen in patients who are rehospitalized within 30 days of discharge


Contact Person: Cindy Bright, E-mail   Phone: 630.909.8027                 
Provide your e-mail address

  • you may use either your personal or Marianjoy e-mail address
  • Article will be e-mailed to you
  • Google Docs/Drive will be used for discussion

For further information or any questions, please contact Cindy Bright

Available Credits: 1.5 Contact Hours

Instructions for receiving the credits:

There are 3 parts to earning CE credit for these articles. All components must be completed between April 1 and April 30, 2014:

  1. After reading the articles, there is a short post-test on the Learning Link. To get to the Learning Link module, open and login to Learning Link, click View course catalog, select All courses, and then enter PRCH4020 to find the April 2014 journal module. You must complete the post-test on or before April 30 and score at least 80% correct to earn CE credit.
  2. An evaluation of this learning opportunity is required to obtain the CE credit. A link to the evaluation will be found at the end of the post-test.
  3. As part of the requirements to earn the CE credit, you must participate in a discussion about the article. This discussion will take place via Google Docs/Drive. A Nursing Journal Club designee will generate the discussion. You must respond / participate in the discussion at least 1 time by April 30 to be compliant.


To add some extra excitement to our Journal Club, we will be offering another $25 gift card in a raffle drawing for members that earn CE credit over the months of October, November, and December/January. Raffle will take place at the end of December/January. Be sure to participate so your name will be included in the drawing. As an additional perk, if a participant encourages another Journal Club member to join in the discussion (and the referred member states the referring member’s name in their discussion), we will add the referring member’s name an additional time in the drawing. Remember that both members must earn their CE credit for the month for the referring member to be entered an additional time in the drawing.

The winner will be notified by e-mail and the gift card will be sent to them within 2 weeks after the close of the month.

Instructions to access the Google Docs/Drive Web page for Discussion and to post comments:
  • Click on Google Docs/Drive or the following Link/URL:
  • Ignore the message to upgrade to a modern browser, such as Google Chrome and click on Dismiss (this message may appear on the top)
  • Click on the Comments button (top Right hand) to add your comment
  • Please sign your full name after each comment
  • After typing your comments, click on Comments one more time; you will be able to see your comments
  • For a reply to a specific comment, you may use the Reply button; the comment will appear next to that specific comment, or you may generate your own comment


It should take you approximately 1.5 hours to read the articles, take the quiz and complete the evaluation. 

As a member of the Nursing Journal Club, you will automatically receive subsequent articles on the first of each month. If you would like to cancel your membership at any time, please contact Cindy Bright via e-mail or contact her at 630.909.8027. We will send out a flyer announcing the next article approximately 2 weeks prior to sending it out.

We are excited that you are interested in this new opportunity. We welcome any comments or suggestions you may have.

Marianjoy Rehabilitation Hospital- Professional Practice Committee, (OH-387, 9/28/2013) is an approved provider of continuing nursing education by the Ohio Nurses Association (OBN-001-91), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

As required by the American Nurses Credentialing Center’s Accreditation Program, we would like to make you aware of all potential conflicts of interest(s). This educational activity’s planners and presenters have indicated that they have no bias or conflict of interest. Marianjoy Rehabilitation Hospital has not received any commercial support for this program. There will not be any endorsement of products or discussion of off-lable use.

The Marianjoy Online Nursing Journal Club is a joint effort between the Nursing Department, the Medical Library, and the Research Department







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