scholarly journals Quality evaluation questionnaires – nursing homes (QEQ-NH); validation of questionnaires for measuring quality of care in nursing homes from various perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mattanja Triemstra ◽  
Juliane Menting ◽  
Bellis van den Berg
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Family Caregivers ◽  
Content Validity ◽  
Quality Evaluation ◽  
Nursing Home Care ◽  
Cognitive Interviews ◽  
National Quality

Abstract Background This study aims to describe the validation and optimization of a new instrument designed to comprehensively measure and evaluate the quality of care in nursing homes; the Quality Evaluation Questionnaires for Nursing Homes (QEQ-NH). This instrument comprises several questionnaires on the perceived quality of care for various perspectives (e.g. clients, family and professional caregivers) and covers eight themes of the national quality framework for nursing home care in the Netherlands. Methods Data were collected in six nursing homes between September 2017 and June 2018, among 359 residents, 48 family caregivers and 648 professional caregivers who completed a subgroup-specific questionnaire of the QEQ-NH. Construct and criterion validity of the three questionnaires were tested with item- and scale analyses. Content validity of the questionnaires was tested in cognitive interviews with 20 participants (7 residents, 5 family caregivers and 8 professional caregivers). Results Psychometric analyses confirmed the multidimensionality and reliability of the three questionnaires, and the cognitive interviews showed various possibilities for further optimization of the instrument. Construct, criterion and content validity of the three questionnaires ranged from acceptable to good. Cronbach’s alphas were > .70 for almost all scales. More than half of the items were candidate for optimization according to the cognitive interviews, mainly due to clarity or knowledge problems, and the questionnaires of the QEQ-NH were optimized accordingly. Conclusions The Quality Evaluation Questionnaires for Nursing Homes (QEQ-NH) provide a solid basis to measure the quality of nursing home care, by covering the national quality themes and by integrating the various perspectives of all parties involved. With real-time feedback, the instrument provides the management and care teams with information to select possibilities or areas for improvement and to continuously monitor the effects of quality improvement in nursing homes.

scholarly journals Quality Improvement Questionnaires – Nursing Homes (QIQ-NH): validation of questionnaires for measuring quality of care in nursing homes from various perspectives

2020 ◽  
Author(s):  
Mattanja Triemstra ◽  
Juliane Menting ◽  
Bellis van den Berg
Keyword(s):  
Quality Improvement ◽  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Family Caregivers ◽  
Content Validity ◽  
Nursing Home Care ◽  
Cognitive Interviews ◽  
National Quality

Abstract Background This study aims to describe the validation and optimization of a new instrument specifically designed to measure and improve the quality of care in nursing homes; the Quality Improvement Questionnaires for Nursing Homes (QIQ-NH). This instrument comprises several questionnaires on the perceived quality of care for various perspectives (e.g. clients, family and professional caregivers) and covers eight themes of the national quality framework for nursing home care in the Netherlands. Methods Data was collected in six nursing homes between September 2017 and June 2018, among 359 residents, 48 family caregivers and 648 professional caregivers who completed a subgroup-specific questionnaire of the QIQ-NH. The construct and criterion validity of the three questionnaires were tested with item- and scale analyses. The content validity of the questionnaires was tested in cognitive interviews with 20 participants (7 residents, 5 family caregivers, 8 professional caregivers). Results Psychometric analyses confirmed the multidimensionality and reliability of the three questionnaires, and the cognitive interviews showed various possibilities for further optimization of the instruments. The construct, criterion and content validity of the three questionnaires ranged from acceptable to good. Cronbach’s alphas were > .70 for almost all scales. More than half of the items were candidate for optimization according to the cognitive interviews, mainly due to clarity or knowledge problems, and the questionnaires of the QIQ-NH were optimized accordingly. Conclusions The Quality Improvement Questionnaires for Nursing Homes (QIQ-NH) provides a solid basis to continuously measure and improve the quality of nursing home care, by covering the national quality themes and by integrating the various perspectives of all parties involved. With real-time feedback, the instrument enables the management and care teams to select possibilities or areas for improvement and to implement and continuously monitor the effects of quality improvement strategies in nursing homes.

The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review

Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Scoping Review ◽  
Informal Caregivers ◽  
Nursing Home Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.

scholarly journals Analyzing Nursing Home Complaints: From Substantiated Allegation to Deficiency Citations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 82-83
Author(s):  
Kallol Kumar Bhattacharyya ◽  
Lindsay Peterson ◽  
John Bowblis ◽  
Kathryn Hyer
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Staff Training ◽  
Policy And Practice ◽  
Abuse And Neglect ◽  
The Relationship ◽  
Investigation Process

Abstract Complaints provide important information to consumers about nursing homes (NHs). Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Because a complaint may contain multiple allegations, and the data do not identify which allegation(s) lead to a complaint’s substantiation, we identified all substantiated single allegation complaints for NHs in 2017. Our data were drawn from federally collected NH complaint and inspection records. Among the 369 substantiated single-allegation complaints, we found most were categorized as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Of the deficiency citations resulting from complaints in our sample, 27.9% were categorized as quality of care and 19.5% were in the category of resident behavior and facility practices, which includes abuse and neglect. While two-thirds (N=239) of the substantiated complaints generated from 1 to 19 deficiency citations, nearly one third had no citations. Surprisingly, 28% of substantiated abuse and neglect allegations resulted in no deficiency citations. More surprisingly, a fifth of complaints that were categorized as “immediate jeopardy” at intake did not result in any deficiency citations. We also found a number of asymmetries in the allegation categories suggesting different processes by Centers for Medicare and Medicaid Services (CMS) region. These results suggest that the compliant investigation process warrants further investigation. Other policy and practice implications, including the need for better and more uniform investigation processes and staff training, will be discussed.

scholarly journals Racial and Ethnic Disparities in Pain Management for Nursing Home Residents: A Scoping Review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 885-885
Author(s):  
Cassandra Dictus ◽  
Youngmin Cho ◽  
Tamara Baker ◽  
Anna Beeber
Keyword(s):  
Nursing Home ◽  
Pain Management ◽  
Nursing Homes ◽  
Racial Disparities ◽  
Racial Differences ◽  
Racial Bias ◽  
Nursing Home Residents ◽  
Ethnic Disparities ◽  
Nursing Home Care

Abstract Within nursing homes, residents commonly experience pain that unfortunately goes underrecognized and undertreated, having a dramatic negative impact on residents' quality of life. Nursing homes are becoming more racially and ethnically diverse, and there is concerning evidence documenting disparities in the quality of nursing home care. In other healthcare settings, people of diverse race groups often receive less optimal pain management, but the evidence regarding racial disparities has not been synthesized for nursing homes. Thus, the purpose of this review was to investigate what is known about racial disparities related to pain management (e.g. assessment, treatment, preferences) in US nursing homes. We completed a scoping literature review using PRISMA-ScR guidelines and searching PubMed, CINHAL, and Scopus for peer-reviewed, empirical studies. Most studies were older large retrospective cohort studies of administrative data documenting that White residents were more likely than residents of diverse race groups to have pain documented and treated. Only a few studies looked at possible reasons to explain the disparities; differences were not found to be related to nursing staff racial bias nor differences in pain-related diagnoses. However, there was evidence of racial differences in resident behavior and attitudes related to pain management. None of the studies examined systemic factors related to differences among nursing homes, which has been implicated in studies looking at other outcomes including COVID-19. More research is needed which examines the causal mechanisms behind the documented racial disparities in pain management so that gaps in care can be reduced.

Medical Staffing Organization and Quality of Care Outcomes in Post-acute Care Settings

2020 ◽  
Author(s):  
Laura M Wagner ◽  
Paul Katz ◽  
Jurgis Karuza ◽  
Connie Kwong ◽  
Lori Sharp ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Acute Care ◽  
Quality Measures ◽  
Medical Providers ◽  
Medical Provider ◽  
Provider Characteristics ◽  
The Impact

Abstract Background and Objectives Medical providers are significant drivers of care in post-acute long-term care (PALTC) settings, yet little research has examined the medical provider workforce and its role in ensuring quality of care. Research Design and Methods This study examined the impact of nursing home medical staffing organization (NHMSO) dimensions on the quality of care in U.S. nursing homes. The principal data source was a survey specifically designed to study medical staff organization for post-acute care. Respondents were medical directors and attending physicians providing PALTC. We linked a number of medical provider and nursing home characteristics to the Centers for Medicaid and Medicare Services Nursing Home Compare quality measures hypothesized to be sensitive to input by medical providers. Results From the sample of nursing home medical providers surveyed (n = 1,511), 560 responses were received, yielding a 37% response rate; 425 medical provider responses contained sufficient data for analysis. The results of the impact of NHMSO dimensions were mixed, with many domains not having any significance or having negative relationships between provider characteristics and quality measures. Respondents who reported having a formal process for granting privileges and nursing homes with direct employment of physicians reported significantly fewer emergency visits. Discussion and Implications Further research is needed regarding what quality measures are sensitive to both medical provider characteristics and NHMSO characteristics.

Two Decades of Nursing Home Compare: What Have We Learned?

2020 ◽  
pp. 107755872093165
Author(s):  
R. Tamara Konetzka ◽  
Kevin Yan ◽  
Rachel M. Werner
Keyword(s):  
Systematic Review ◽  
Quality Improvement ◽  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Risk Adjustment ◽  
Public Reporting ◽  
Review Of The Literature ◽  
Nursing Home Compare

Approximately two decades ago, federally mandated public reporting began for U.S. nursing homes through a system now known as Nursing Home Compare. The goals were to provide information to enable consumers to choose higher quality nursing homes and to incent providers to improve the quality of care delivered. We conduct a systematic review of the literature on responses to Nursing Home Compare and its effectiveness in meeting these goals. We find evidence of modest but meaningful response by both consumers and providers. However, we also find evidence that some improvement in scores does not reflect true quality improvement, that disparities by race and income have increased, that risk-adjustment of the measures is likely inadequate, and that several key domains of quality are not represented. Our results support moderate success of Nursing Home Compare in achieving intended goals but also reveal the need for continued refinement.

Purchasing or Providing Nursing Home Care: Can Quality of Care Data Provide Guidance

2005 ◽  
Vol 53 (4) ◽  
pp. 603-608 ◽  
Author(s):  
Dan R. Berlowitz ◽  
Amy K. Rosen ◽  
Fei Wang ◽  
Dionyssios Tsilimingras ◽  
Pierre N. Tariot ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Home Care ◽  
Nursing Home Care

scholarly journals Nursing home quality of life in the Lebanon

2017 ◽  
Vol 18 (2) ◽  
pp. 145-156
Author(s):  
Marina Gharibian Adra ◽  
John Hopton ◽  
John Keady
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Family Caregivers ◽  
Comparative Method ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Care Practice ◽  
Content Type

Purpose The purpose of this paper is to explore perceptions, perspectives and meaning of quality of life for a sample of older residents, care staff and family caregivers in two nursing homes in Lebanon. Design/methodology/approach A classic grounded theory study was conducted between 2010 and 2011 in two nursing homes in Beirut. The semi-structured interviews were undertaken with a theoretical sample of 20 residents, 8 family caregivers and 11 staff. The constant comparative method was used to analyze the data. Findings Three distinct but interrelated properties of quality of life emerged from this process: “maintaining self,” “maintaining identity” and “maintaining continuity”. The dynamics that exist within and between each of these properties provide an indicator about shared and distinct meanings and the implications for care practice. Research limitations/implications The study was conducted in one city in Lebanon; accordingly, the transferability of findings may be challenging. Practical implications Implications for nursing and nursing policy – improving Lebanese national standards and regulations applicable to nursing home residents may help to enhance residents’ care needs and quality of life. Social implications There was limited guidance aimed at helping older residents to voice and increase their choice and control. Originality/value This paper provides new insights into the process of outlining the properties attached to the phenomenon of quality of life in nursing homes in Lebanon. It will be of interest to those in nursing home care as well as to policy makers.

Quality of dying of nursing home residents with dementia as judged by relatives

2013 ◽  
Vol 25 (10) ◽  
pp. 1697-1707 ◽  
Author(s):  
Nicole van Uden ◽  
Lieve Van den Block ◽  
Jenny T. van der Steen ◽  
Bregje D. Onwuteaka-Philipsen ◽  
An Vandervoort ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Retrospective Study ◽  
Nursing Homes ◽  
The Netherlands ◽  
Nursing Home Residents ◽  
Quality Of Dying ◽  
People With Dementia ◽  
Number Of Patients

ABSTRACTBackground:Providing good quality care for the growing number of patients with dementia is a major challenge. There is little international comparative research on how people with dementia die in nursing homes. We compared the relative's judgment on quality of care at the end of life and quality of dying of nursing home residents with dementia in Belgium and the Netherlands.Methods:This was a Belgian cross-sectional retrospective study (2010) combined with a prospective and retrospective study from the Netherlands (January 2007–July 2011). Relatives of deceased residents of 69 Belgian and 34 Dutch nursing homes were asked to complete questionnaires. We included 190 and 337 deceased nursing home residents with dementia in Belgium and the Netherlands, respectively.Results:Of all identified deceased nursing home residents with dementia, respectively 53.2% and 74.8% of their relatives in Belgium and the Netherlands responded. Comfort while dying (CAD-EOLD, range 14–42) was rated better for Dutch nursing home residents than for Belgian nursing homes residents (26.1 vs. 31.1, OR 4.5, CI 1.8–11.2). We found no differences between countries regarding Satisfaction With Care (SWC-EOLD, range 10–40, means 32.5 (the Netherlands) and 32.0 (Belgium)) or symptom frequency in the last month of life (SM-EOLD, range 0–45, means 26.4 (the Netherlands) and 27.2 (Belgium)).Conclusion:Although nursing home structures differ between Belgium and the Netherlands, the quality of care in the last month of life for residents with dementia is similar according to their relatives. However, Dutch residents experience less discomfort while dying. The results suggest room for improved symptom management in both countries and particularly in the dying phase in Belgium.

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