Accepted for/Published in: JMIR Nursing
Date Submitted: Mar 27, 2025
Open Peer Review Period: Mar 27, 2025 - May 22, 2025
Date Accepted: Oct 6, 2025
Date Submitted to PubMed: Oct 27, 2025
(closed for review but you can still tweet)
Socio-technical Needs of Registered Nurses in the Heart Failure Hospitalizations of African Americans: A Cross-sectional Study
ABSTRACT
Background:
African Americans are disproportionately impacted by congestive heart failure The impact includes a 2.5 times greater hospitalization rate and a fourth of a day longer length of hospital stay than Caucasians, of which nursing care has been associated with nearly a 30% decrease in hospitalizations and readmissions. Prior studies have demonstrated that registered nurses, working in conjunction with EHRs to conduct these care tasks, may improve hospitalization outcomes in African Americans with congestive heart failure.
Objective:
The objective of the study was to identify the needs of registered nurses who performed socio-technical tasks, and the relative perceived importance and performance of these socio-technical tasks, in relation to the length of stay of their patients.
Methods:
The study employed a cross-sectional survey design on a sample of 200 nurses registered nurses who were randomly selected from a total population of 3,498 registered nurses who provided care to 22,703 patients with congestive heart failure within 113,543 heart failure hospitalizations between January 1, 2015, and January 1, 2024. The 200 nurses were split into two groups: registered nurses who had CHF patients with a mean length of stay of 10 days or less and those who had patients with a mean length of stay of more than 10 days. Descriptive statistics, Cohen’s d, and a two-sided unpaired t-test were used to identify the relative perceived importance of these socio-technical tasks and the perceived performance of these tasks in relation to the length of stay of their patients.
Results:
The study identified 17 significant socio-technical needs of registered nurses, the perceived importance of these socio-technical tasks, the self-perceived performance of these tasks, and the relation to the length of stay of patients. There were two socio-technical needs unique to registered nurses who had patients with more than 10 days: caring for patients (i.e., the full scope of social and technological processes in nursing care) (CD=0.32, 95% CI: 0.04,0.59, P = .04) and working with information related to a patient's CHF in the EHR (e.g., laboratory results, discharge summaries, or radiographic images) to care for the patient (CD= 0.33, 95% CI: 0.05,0.61, P = .034).
Conclusions:
Lengths of patient stay may be reduced by identifying and addressing socio-technical needs through targeted nurse training, nursing care, nurse-centered EHR interventions, and nurse-led risk stratification guidelines for working with EHRs to reduce lengths of stay in those who are disproportionately impacted by CHF. Clinical Trial: N/a
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