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

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.

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

BMC Geriatrics ◽

10.1186/s12877-021-02388-3 ◽

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.

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Developing a Fracture Risk Clinical Assessment Protocol for Long-Term Care: A Modified Delphi Consensus Process

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2020.08.015 ◽

2020 ◽

Author(s):

Caitlin McArthur ◽

Loretta Hillier ◽

George Ioannidis ◽

Jonathan D. Adachi ◽

Lora Giangregorio ◽

...

Keyword(s):

Fracture Risk ◽

Clinical Assessment ◽

Long Term Care ◽

Delphi Consensus ◽

Consensus Process ◽

Term Care ◽

Assessment Protocol ◽

Modified Delphi

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Attitudes Toward Sexual Behaviors in Long-Term Care: Development of an Assessment Tool

Innovation in Aging ◽

10.1093/geroni/igaa057.2031 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 602-603

Author(s):

Rachael Spalding ◽

Emma Katz ◽

Barry Edelstein

Keyword(s):

Sexual Behaviors ◽

Long Term Care ◽

Assessment Tool ◽

Qualitative Interviews ◽

Family Members ◽

Community Dwelling ◽

Term Care ◽

Care Development

Abstract Most older adults living in long-term care settings (LTCs) indicate that expressing their sexuality is important to them (Doll, 2013). Little is known about the general public’s attitudes towards sexual behaviors in LTCs. Attitudes of LTC residents’ family members are particularly important, as family members are most likely to visit residents and to care about their quality of life. Family members’ attitudes could in turn inform facility policies and management. We will present preliminary data from a series of qualitative interviews with community-dwelling adults regarding their attitudes. We will discuss how these data are being used to inform current work on a measure of attitudes toward sexual behavior in LTCs.

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A Study on the New Assessment Tool for Determining Eligibility for Long-term Care in Germany

Health and Social Welfare Review ◽

10.15709/hswr.2014.34.1.207 ◽

2014 ◽

Vol 34 (1) ◽

pp. 207-238 ◽

Cited By ~ 2

Author(s):

남현주

Keyword(s):

Long Term Care ◽

Assessment Tool ◽

Term Care

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Health status, care needs, and assessment for beneficiaries with or without dementia in a public long-term care insurance pilot in Guangzhou, China

BMC Health Services Research ◽

10.1186/s12913-020-05965-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jialan Wu ◽

Siman Chen ◽

Huangliang Wen ◽

Yayan Yi ◽

Xiaoyan Liao

Keyword(s):

Barthel Index ◽

Rasch Analysis ◽

Long Term Care ◽

Assessment Tool ◽

Chinese Government ◽

Care Needs ◽

Term Care ◽

Depth Analysis ◽

Long Term Care Insurance

Abstract Background Chinese government launched a pilot study on public long-term care insurance (LTCI) recently. Guangzhou is one of the fifteen pilot cities, officially started providing LTCI in August 2017. An in-depth analysis of experimental data from the pilot city may provide suggestions for developing a fair and effective LTCI system. This study aimed to evaluate the LTCI pilot by exploring the characteristics and care needs of claimants, and performance of the assessment tool. Methods A retrospective cross-sectional study in which claims data between July 2018 and March 2019 in the Guangzhou pilot was analyzed. LTCI claimants during the study period were included. The care needs were determined based on claimants’ physical function assessed by the Barthel Index and their medical conditions. Rasch analysis was used to explore the performance of the Barthel Index. Results Among 4810 claimants included, 4582 (95.3%) obtained LTCI benefits. Of these beneficiaries, 4357 (95.1%) were ≧ 60 years old, and 791 (17.3%) had dementia. Among 228 (4.7%) unsuccessful claimants, 22 (0.5%) had dementia. The prevalence of stroke was high in beneficiaries with (38.1%) or without dementia (56.6%), as well as in unsuccessful claimants with (40.9%) or without dementia (52.4%). Beneficiaries without dementia needed more support for basic activities of daily living and nursing care than those with dementia, while beneficiaries with dementia were more likely to be institutionalized. Five (22.7%) unsuccessful claimants with dementia and 48 (23.3%) unsuccessful claimants without dementia were disabled in at least two basic self-care activities. Regarding Barthel Index, Rasch analysis showed threshold disordering in “mobility” and “climbing stairs”, and the narrow interval was observed between all the adjacent categories of the ten items (< 1.4 logits). Conclusions Stroke and dementia were two common reasons for needing long-term care in LTCI claimants. The Barthel Index is not suitable for assessing and dividing LTCI claimants, because of inappropriate items and narrow category responses. A comprehensive assessment and grading system is required, together with needs-led care services. The eligibility should be expanded gradually based on balance finance solutions.

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