Association between continuity of nursing care and older adults' hospitalization outcomes: A retrospective observational study

Orly Tonkikh, Anna Zisberg, Efrat Shadmi

Research output: Contribution to journalArticlepeer-review


Aim: To assess the relationship between continuity in nursing assignment in older adults' acute hospitalization and patient experience and functional decline. Background: In-hospital functional decline affects up to 40% of hospitalized older adults. Nurses are responsible for performing functioning-preserving interventions. Whether continuity of nursing care contributes to patients' functional outcomes is unclear. Method: A retrospective observational study of 609 patients aged ≥70 admitted to internal medicine units. Patients were surveyed on their functional (cognitive and physical) status and satisfaction with the hospital care experience. Dispersion and sequence of nursing assignment were measured by the Continuity of Care Index and Sequential Continuity Index. Multivariate logistic regressions were modelled for each continuity score and outcome. Results: Achieving 25% of the maximum Continuity of Care Index was associated with lower odds of cognitive decline (OR = 0.64, 95% CI = 0.43–0.94) and higher odds of satisfaction (OR = 1.52, 95% CI = 1.06–2.17). Achieving 25% of the maximum Sequential Continuity Index was associated only with higher odds of satisfaction (OR = 1.43, 95% CI = 1.01–2.02). Continuity scores were not associated with physical functioning decline. Conclusion: Continuity in nursing assignment is related to a positive patient experience and cognitive functioning of hospitalized older adults. Implications for Nursing Management: Continuity should be prioritized in scheduling and assignment algorithms.

Original languageEnglish
Pages (from-to)1062-1069
Number of pages8
JournalJournal of Nursing Management
Issue number5
StatePublished - 1 Jul 2020

Bibliographical note

Funding Information:
This work is a part of PhD studies supported by the Cheryl Spencer Institute of Nursing Research, University of Haifa and the Ministry of Science and Technology travel grant [Number 3‐15471]. This study is based on data from the Hospitalization Process Effects on Functional Outcomes and Recovery (HoPE‐FOR) study supported by the Israel Science Foundation [Grant Number 565/08], Clalit Health Services [Grant Number 04‐121/2010] and the Israel National Institute for Health Policy Research [Grant Number 78/2013]. The funding agencies had no role in the study design; the collection, analysis and interpretation of the data; or the preparation of the manuscript.

Publisher Copyright:
© 2020 John Wiley & Sons Ltd


  • aged
  • cognition
  • continuity of patient care
  • hospitalization
  • nursing care

ASJC Scopus subject areas

  • Leadership and Management


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