Randomized Clinical Trial of a Quality Improvement Intervention in Nursing Homes
| Autor: | Lanis L. Hicks, Marilyn Rantz, David R. Mehr, Rose Porter, Mary Zwygart-Stauffacher, Gregory F. Petroski, Meridean Maas, Deidre D. Wipke-Tevis, Victoria T. Grando, Vicki S. Conn, Jane Bostick, Lori Popejoy, Richard W. Madsen |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
medicine.medical_specialty
Quality management Consultants Quality Assurance Health Care MEDLINE Clinical nurse specialist Education Feedback law.invention Nursing Randomized controlled trial law Intervention (counseling) Health care Homes for the Aged Humans Medicine Aged Quality Indicators Health Care Aged 80 and over Minimum Data Set business.industry General Medicine Nursing Homes Clinical trial Outcome and Process Assessment Health Care Family medicine Geriatrics and Gerontology business Gerontology Total Quality Management |
| Zdroj: | The Gerontologist. 41:525-538 |
| ISSN: | 1758-5341 0016-9013 |
| Popis: | Purpose The purpose of the study was to determine if simply providing nursing facilities with comparative quality performance information and education about quality improvement would improve clinical practices and subsequently improve resident outcomes, or if a stronger intervention, expert clinical consultation with nursing facility staff, is needed. Design and methods Nursing facilities (n = 113) were randomly assigned to one of three groups: workshop and feedback reports only, workshop and feedback reports with clinical consultation, and control. Minimum Data Set (MDS) Quality Indicator (QI) feedback reports were prepared and sent quarterly to each facility in intervention groups for a year. Clinical consultation by a gerontological clinical nurse specialist (GCNS) was offered to those in the second group. Results With the exception of MDS QI 27 (little or no activity), no significant differences in resident assessment measures were detected between the groups of facilities. However, outcomes of residents in nursing homes that actually took advantage of the clinical consultation of the GCNS demonstrated trends in improvements in QIs measuring falls, behavioral symptoms, little or no activity, and pressure ulcers (overall and for low-risk residents). Implications Simply providing comparative performance feedback is not enough to improve resident outcomes. It appears that only those nursing homes that sought the additional intensive support of the GCNS were able to effect enough change in clinical practice to improve resident outcomes significantly. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|