scholarly journals RELIABILITY OF THE DINING ENVIRONMENT ASSESSMENT PROTOCOL AND THE MEALTIME SCAN FOR LONG TERM CARE

2016 ◽  
Vol 56 (Suppl_3) ◽  
pp. 476-476
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Assessment Protocol ◽  
Environment Assessment

Evaluation of the Predictive Accuracy of the interRAI Falls Clinical Assessment Protocol, Scott Fall Risk Screen, and a Supplementary Falls Risk Assessment Tool Used in Residential Long-Term Care: A Retrospective Cohort Study

2020 ◽  
Vol 39 (4) ◽  
pp. 521-532
Author(s):  
Kathleen J. Norman ◽  
John P. Hirdes
Keyword(s):  
Risk Assessment ◽  
Cohort Study ◽  
Fall Risk ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Predictive Accuracy ◽  
Term Care ◽  
Assessment Protocol ◽  
Residential Long Term Care

ABSTRACTFalls in residential long-term care (LTC) facilities continue to be a leading cause of injury for residents and cost for the health care system. Interdisciplinary clinical teams are responsible for assessing risk levels for their residents and developing appropriate care plans and interventions in response. This study compares the predictive accuracy of three separate fall risk assessment tools: the interRAI Falls Clinical Assessment Protocol (CAP), derived from the LTC Facility (LTCF) or Minimum Data Set (MDS) 2.0 assessments; the Scott Fall Risk Screen; and a modified Fall Risk Tool that was implemented as part of a provincial Fall Reduction Strategy in Nova Scotia. To conduct this retrospective cohort study, secondary data were collected from 1,553 LTC residents with interRAI assessments completed between March 1, 2015 and September 29, 2016, across Nova Scotia and New Brunswick. For each resident, data were collected regarding the three fall risk assessments, along with fall incident data for use in sensitivity, specificity, and logistic regression analyses. This study found that although all three tools had limitations with sensitivity or specificity thresholds, the interRAI Falls CAP delivered the highest accuracy with a c-statistic of 0.673, compared with the Scott Fall Risk Screen at 0.529 and the modified Fall Risk Tool at 0.609. When diseases that have been established to be a risk factor for falls were added to the model, the overall accuracy of the interRAI Falls CAP combined with those covariates increased to 0.749. These results suggest that the best practice guidelines for fall risk assessment be revisited, and that the interRAI Falls CAP could potentially be updated to include certain diseases and controls for optimal predictive ability.

scholarly journals Strategies for the implementation of an electronic fracture risk assessment tool in long term care: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuxin Bai ◽  
Caitlin McArthur ◽  
George Ioannidis ◽  
Lora Giangregorio ◽  
Sharon Straus ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Long Term Care ◽  
Assessment Tool ◽  
Implementation Strategies ◽  
High Fracture ◽  
Term Care ◽  
Assessment Protocol ◽  
Fracture Risk Assessment Tool ◽  
Group Interviews

Abstract Background Older adults in long-term care (LTC) homes experience high rates of fractures, which are detrimental to their quality of life. The purpose of this study is to identify and make recommendations on strategies to implementing an evidence-based Fracture Risk Clinical Assessment Protocol (CAP) in LTC. Methods Following the Behaviour Change Wheel framework, we conducted six focus group interviews with a total of 32 LTC stakeholders (e.g. LTC physicians) to identify barriers and facilitators, suggest implementation strategies, and discuss whether the identified strategies were affordable, practicable, effective, acceptable, safe, and if they promote equity (APEASE). The interviews were transcribed verbatim and analyzed using thematic content analysis. Results Themes of implementation strategies that met the APEASE criteria were minimizing any increase in workload, training on CAP usage, education for residents and families, and persuasion through stories. Other strategy themes identified were culture change, resident-centred care, physical restructuring, software features, modeling in training, education for staff, social rewards, material rewards, public benchmarking, and regulations. Conclusions To implement the Fracture Risk CAP in LTC, we recommend using implementation strategies centred around minimizing any increase in workload, training on CAP usage, providing education for residents and families, and persuading through stories. Through improving implementation of the fracture risk CAP, results from this work will improve identification and management of LTC residents at high fracture risk and could inform the implementation of guidelines for other conditions in LTC homes.

scholarly journals Strategies for the Implementation of an Electronic Fracture Risk Assessment Tool in Long Term Care: A Qualitative Study

2021 ◽  
Author(s):  
Yuxin Bai ◽  
Caitlin McArthur ◽  
George Ioannidis ◽  
Lora Giangregorio ◽  
Sharon Straus ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Long Term Care ◽  
Assessment Tool ◽  
High Fracture ◽  
Term Care ◽  
Assessment Protocol ◽  
Fracture Risk Assessment Tool ◽  
Group Interviews ◽  
Social Rewards

Abstract Background: Older adults in long-term care (LTC) homes experience high rates of fractures, which are detrimental to their quality of life. The purpose of this study is to identify and make recommendations on knowledge translation interventions to implementing an evidence-based Fracture Risk Clinical Assessment Protocol (CAP) in LTC. Methods: Following the Behaviour Change Wheel framework, we conducted focus group interviews with 32 LTC stakeholders (e.g. LTC physicians) to identify barriers and facilitators, suggest intervention options, and discuss whether the identified interventions were feasible. The interviews were transcribed verbatim and analyzed using thematic content analysis. Results: The intervention themes that met the APEASE criteria were minimizing any increase in workload, training on CAP usage, education for residents and families, and persuasion through stories. Other intervention themes identified were culture change, resident-centred care, physical restructuring, software features, modeling in training, education for staff, social rewards, material rewards, public benchmarking, and regulations. Conclusions: To implement the Fracture Risk CAP in LTC, KT interventions centred around minimizing any increase in workload, training on CAP usage, providing education for residents and families, and persuading through stories may be used. Results from this work will improve identification and management of LTC residents at high fracture risk and could inform the implementation of guidelines for other conditions in LTC homes.

Working With Resistance and Encouraging Buy-In to New Programs

2011 ◽  
Vol 16 (1) ◽  
pp. 18-21
Author(s):  
Sara Joffe
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Optimal Outcomes ◽  
Speech Language Pathologist

In order to best meet the needs of older residents in long-term care settings, clinicians often develop programs designed to streamline and improve care. However, many individuals are reluctant to embrace change. This article will discuss strategies that the speech-language pathologist (SLP) can use to assess and address the source of resistance to new programs and thereby facilitate optimal outcomes.

Feeding Dependency Issues in the Long-Term Care Environment

2001 ◽  
Vol 10 (1) ◽  
pp. 19-24
Author(s):  
Carol Winchester ◽  
Cathy Pelletier ◽  
Pete Johnson
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Care Environment

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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