Evaluating the Quality of Nursing Home Care

Abstract

Evaluation of the quality of care that a nursing home patient receives is difficult and requires physician participation as well as the participation of specially trained nursing personnel. A form of limited medical audit is suggested to aid in such evaluation. In the proprietary nursing home studied by the authors, the quality of care was not being effectively assessed by the survey process then employed. In addition to other factors, emphasis is now placed on the avoidance of additional costs or extra paper work in the process of determining the quality of care.

Drug Utilization and Prescribing Patterns in a Skilled Nursing Facility: The Need for a Rational Approach to Therapeutics

“…Evaluation of the quality of medical care in a SNF is difficult (22) and it was our experience that cooperation from the attending physicians and skilled nursing personnel usually was not readily accorded. This reserved attitude suggests the need for greater efforts to establish a better rapport and enforce more effective means of auditing drug prescribing patterns and care plans for the patients.…”

The Quality of Medical Care Received by Older Persons

“…Studies of prescribing patterns in nursing homes report inappropriate prescription of diuretics 32 and antipsychotics 33 ; also many incontinent patients receive drugs that could further impair bladder control 29 . Drugs are frequently inappropriately prescribed on an “as needed” basis, 34–35 the exact meaning of which is not specified to the nursing staff 27 . Reviewing medical records in a skilled nursing facility, Segal et al 36 found that there were no indications for 60% of the drugs prescribed.…”