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Practice sensitive quality indicators in RAI-MDS 2.0 nursing home data.
Carole A Estabrooks1, Jennifer A Knopp-Sihota, Peter G Norton
1Faculty of Nursing, University of Alberta, Edmonton, Alberta T6G 1C9, Canada. carole.estabrooks@ualberta.ca.
BMC Research Notes
|November 14, 2013
Summary
Identifying practice-sensitive quality indicators (QIs) in nursing homes is crucial. Pressure ulcers, pain, physical restraints, antipsychotic use, and catheters are key indicators most responsive to clinical practice improvements.
Area of Science:
- Gerontology
- Healthcare Quality Improvement
- Nursing Home Care
Background:
- Improving nursing home resident care quality is a significant focus.
- Quality Indicators (QIs) from the Resident Assessment Instrument-Minimum Data Set 2.0 (RAI-MDS 2.0) serve as proxy measures for care quality.
- The study aimed to identify QIs most sensitive to clinical practice.
Purpose of the Study:
- To identify practice-sensitive Quality Indicators (QIs) within the Resident Assessment Instrument-Minimum Data Set 2.0 (RAI-MDS 2.0).
- To determine which QIs are most responsive to clinical practice interventions in nursing homes.
Main Methods:
- Two experts reviewed 35 validated QIs to select those most sensitive to practice.
- Practicing physicians, nurses, and policymakers ranked QIs for practice sensitivity.
- Participants identified the care domain (nursing, physician, or policy) most relevant to each QI.
Main Results:
- Pressure ulcers were identified as the most practice-sensitive QI.
- Other highly sensitive QIs included worsening pain, physical restraint use, antipsychotic medication use without psychosis diagnosis, and indwelling catheters.
- While the top five QIs were consistent across groups, their specific ranking varied among physicians, nurses, and policymakers.
Conclusions:
- A focused set of 13 practice-sensitive QIs can be used for regular reporting.
- Prioritizing these QIs offers the greatest potential to enhance resident function and mitigate decline.
- These indicators can guide targeted interventions to improve nursing home care quality.
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