Quality of care in Icelandic nursing homes measured with Minimum Data Set quality indicators: Retrospective analysis of nursing home data over 7 years

Hjaltadóttir, Ingibjörg; Ekwall, Anna Kristensson; Nyberg, Per; Hallberg, Ingalill Rahm

doi:10.1016/j.ijnurstu.2012.06.004

Cited by 25 publications

(22 citation statements)

References 36 publications

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“…Our results demonstrate that, overall, NHs in Tuscany obtained suboptimal scorings in structural and process quality indicators for nutritional care. In particular, the presence of dietitians in the NH staff and routine, standardized assessment of malnutrition were unacceptably infrequent (23.3 and 11.7 %, respectively), whereas the frequency of application of protocols and guidelines for weight assessment and administration of food, though greater (60 and 65 %) compared to other indicators, remains lower than previously reported in similar settings [ 13 , 43 – 45 ]. Additionally, it is important to highlight that in as many as 43 % of the NHs the degree of dysphagia was not evaluated with standardized tools (43 %), and that scales to weigh residents with severely impaired mobility were unavailable in approximately 60 % of the NHs, whereas a small (3.3 %) of them has no scales whatsoever.…”

Section: Discussionmentioning

confidence: 73%

A cross-sectional survey to investigate the quality of care in Tuscan (Italy) nursing homes: the structural, process and outcome indicators of nutritional care

Bonaccorsi

Collini

Castagnoli

et al. 2015

BMC Health Serv Res

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BackgroundPrevious studies have investigated process and structure indicators of nutritional care as well as their use in nursing homes (NHs), but the relative weight of these indicators in predicting the risk of malnutrition remains unclear.Aims of the present study are to describe the quality indicators of nutritional care in older residents in a sample of NHs in Tuscany, Italy, and to evaluate the predictors of protein-energy malnutrition risk.MethodsA cross-sectional survey was conducted in 67 NHs. Information was collected to evaluate quality indicators of nutritional care and the individual risk factors for malnutrition, which was assessed using the Malnutrition Universal Screening Tool. A multilevel model was used to analyse the association between risk and predictors.ResultsOut of 2395 participants, 23.7 % were at high, 11 % at medium, and 65.3 % at low risk for malnutrition. Forty-two percent of the NHs had only a personal scale to weigh residents; 88 % did not routinely use a screening test/tool for malnutrition; 60 % used some standardized approach for weight measurement; 43 % did not assess the severity of dysphagia; 12 % were not staffed with dietitians.Patients living in NHs where a chair or platform scale was available had a significantly lower risk of malnutrition (OR = 0.73; 95 % CI = 0.56–0.94). None of the other structural or process quality indicators showed a statistically significant association with malnutrition risk.ConclusionsOf all the process and structural indicators considered, only the absence of an adequate scale to weigh residents predicted the risk of malnutrition, after adjusting for case mix. These findings prompt the conduction of further investigations on the effectiveness of structural and process indicators that are used to describe quality of nutritional care in NHs.

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Section: Discussionmentioning

confidence: 73%

A cross-sectional survey to investigate the quality of care in Tuscan (Italy) nursing homes: the structural, process and outcome indicators of nutritional care

Bonaccorsi

Collini

Castagnoli

et al. 2015

BMC Health Serv Res

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“…The significant increase in incontinence in residents with and without dementia may be related to a general increase in care dependency, which is an important risk factor for older people developing urinary or fecal incontinence [ 16 , 27 – 29 ].…”

Section: Discussionmentioning

confidence: 99%

Change in Care Dependency and Nursing Care Problems in Nursing Home Residents with and without Dementia: A 2-Year Panel Study

Schüssler

Lohrmann

2015

PLoS ONE

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Over time, chronic conditions like dementia can lead to care dependency and nursing care problems, often necessitating nursing home admission. This panel study (2012–2014) aims to explore changes in care dependency and nursing care problems (incontinence, malnutrition, decubitus, falls and restraints) in residents with and without dementia over time. In total, nine Austrian nursing homes participated, including 258 residents (178 with, 80 without dementia) who completed all five measurements. Data were collected with the International Prevalence Measurement of Care Problems questionnaire, the Care Dependency Scale and the Mini-Mental State Examination-2. Repeated measures ANOVA and crosstabs were used to analyse changes. The results showed that care dependency in dementia residents increased significantly for all 15 items of the Care Dependency Scale, with the highest increase being residents’ day-/night pattern, contact with others, sense of rules/values and communication. In contrast, care dependency in residents without dementia increased for four of the 15 items, with the highest increase being for continence, followed by getting (un)dressed. With respect to the assessed nursing care problems, residents with dementia and those without only differed significantly in terms of an increase in urinary- (12.3% vs. 14.2%), fecal- (17.4% vs. 10%), and double incontinence (16.7% vs. 11.9%). The results indicated that residents with dementia experienced increased care dependency in different areas than residents without dementia. Furthermore, residents with dementia experienced a lower increase in urinary incontinence but a higher increase in fecal- and double incontinence. These results help professionals to identify areas for improvement in dementia care.

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“…Policies and regulations promoting the reduction in physical restraint and standards in care of older people have been enacted and implemented in many countries (Department of Health ; Hjaltadóttir et al. ; HSE ; Royal College Nursing (RCN) ). Registered nurses and staff need to endorse policy and legislative guidance on restraint (Moore et al.…”

Section: Introductionmentioning

confidence: 99%

“…Recommendations are that restraints can be used in limited circumstance and not as a convenience or measure of control in improving care of older people (Department of Health ; Health Service Executive ; HIQA ; Hjaltadóttir et al. ; RCN ).…”

Section: Introductionmentioning

confidence: 99%

Physical restraint: perceptions of nurse managers, registered nurses and healthcare assistants

Leahy‐Warren

Varghese

Day

et al. 2018

International Nursing Review

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Quality of care in Icelandic nursing homes measured with Minimum Data Set quality indicators: Retrospective analysis of nursing home data over 7 years

Cited by 25 publications

References 36 publications

A cross-sectional survey to investigate the quality of care in Tuscan (Italy) nursing homes: the structural, process and outcome indicators of nutritional care

A cross-sectional survey to investigate the quality of care in Tuscan (Italy) nursing homes: the structural, process and outcome indicators of nutritional care

Change in Care Dependency and Nursing Care Problems in Nursing Home Residents with and without Dementia: A 2-Year Panel Study

Physical restraint: perceptions of nurse managers, registered nurses and healthcare assistants

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