scholarly journals Implementation of the health and social care assessment tool: resident assessment instrument - contact assessment (interrai-ca)

2016 ◽  
Vol 16 (6) ◽  
pp. 15
Author(s):  
Lucia Iñigo Regalado ◽  
Naiara Artaza ◽  
Jose Antonio De La Rica ◽  
Maria Lourdes Zurbanobeaskoetxea ◽  
Maria Inmaculada Sanchez ◽  
...  
2019 ◽  
Vol 25 (2) ◽  
pp. 141-155
Author(s):  
Minna Vuorinen

Background The International Resident Assessment Instrument for Long-Term Care Facilities (interRAI-LTCF) is a Web-based assessment tool designed to comprehensively assess older adults (≥65 years) living in aged residential care. In 2015 New Zealand was the first country where it was made mandatory nationwide. Aims The purpose of this study was to explore Registered Nurses’ (RNs’) experiences, feelings and attitudes towards interRAI-LTCF. Methods Twelve interviews were conducted 18 months after interRAI-LTCF became mandatory. The interview questions were based on a United Theory of Acceptance and Use of Technology model. Findings were analysed thematically. Results The findings reveal that RNs of all ages embrace technology, and have mostly positive attitudes towards interRAI-LTCF. Limited value, however, is seen in dementia and end-of-life care. RNs reported good experiences with trainers and venues, but inconsistency between training courses. Negative feelings towards interRAI-LTCF were caused by insufficient time to complete assessments. RNs also feel apprehensive about the Assessment & Intelligence Systems, Inc. competency tests. Conclusions Overall RNs supported the use of interRAI-LTCF as a comprehensive assessment tool. Duplication in data entry, insufficient training, and the annual tests caused most stress and negative feelings. Recommendations were made to rectify issues.


2020 ◽  
Vol 32 (8) ◽  
pp. 1003-1008
Author(s):  
Yvette Hall ◽  
Philippa Greco ◽  
Kenny Hau ◽  
Yoram Barak

ABSTRACTOlder adult abuse (OAA), defined as abuse, neglect, or mistreatment of persons aged 65 years or older, is a globally pervasive concern, with severe consequences for its victims. While internationally reported rates of OAA are in the range of 5–20% per annum, New Zealand lacks the necessary data to quantify the issue. However, with a growing aging population, an increase in the prevalence of OAA is predicted. We investigated the extent of OAA in New Zealand, utilizing the mandatory interRAI-HC (International Resident Assessment Instrument-home care assessment) dataset, which included 18,884 interviewees from the Southern District Health Board between 2013 and 2019. Findings confirmed our hypothesis that the interRAI assessment is neither sufficiently sensitive nor specific capturing only 3% from a population of increased frailty and thus at higher risk of abuse. We characterized OAA victims as relatively younger males, depressed, and with impaired decision-making capacity. If the interRAIs were to serve as a preliminary screening tool for OAA in New Zealand, it would be germane to implement changes to improve its detection rate. Further studies are urgently called for to test changes in the interRAI that will aid in identifying often missed cases of OAA better and thus offer protection to this vulnerable population.


2011 ◽  
Vol 31 (2) ◽  
pp. 57-66
Author(s):  
AD Foebel ◽  
JP Hirdes ◽  
GA Heckman ◽  
SL Tyas ◽  
EY Tjam

Introduction Le vieillissement de la population canadienne s’accompagne d’un accroissement du fardeau que représente l’insuffisance cardiaque (IC), affection associée à un taux de morbidité et de mortalité important ainsi qu’à un recours fréquent aux services de santé. Méthodologie Nous avons extrait les données de la base de données du Resident Assessment Instrument-Home Care (RAI-HC) de l’Ontario pour tous les clients bénéficiant de soins à domicile de longue durée et âgés de 65 ans et plus, afin 1) de décrire les caractéristiques démographiques et cliniques des clients de soins à domicile souffrant d’insuffisance cardiaque et 2) d’examiner le recours aux services de santé par les clients de soins à domicile souffrant d’insuffisance cardiaque. Résultats Par rapport aux autres clients de soins à domicile, ceux qui souffrent d’insuffisance cardiaque présentent un état de santé plus instable, consomment davantage de médicaments, affichent un taux plus élevé de comorbidité et ont besoin d’un volume significativement plus élevé de soins infirmiers, ainsi que de services ménagers et culinaires. Ils sont hospitalisés plus fréquemment et font un usage significativement plus élevé des services d’urgence et des soins de première urgence. Analyse Les clients souffrant d’insuffisance cardiaque constituent un groupe plus complexe que les clients des soins à domicile en général. La manière dont les patients prennent en main leur santé doit être adaptée à leurs caractéristiques cliniques, à leurs schémas habituels d’utilisation des services et aux obstacles auxquels ils doivent faire face. Ce constat est particulièrement vrai chez les patients plus âgés, frêles et au profil médical complexe qui souffrent d’insuffisance cardiaque, et ils sont nombreux parmi ceux qui requièrent des services à domicile. Cette étude peut servir d’assise à des initiatives de base permettant d’aider ces clients aux besoins particulièrement grands à gérer leur insuffisance cardiaque à domicile grâce à de l’aide et à des services adaptés.


2016 ◽  
Vol 21 (11) ◽  
pp. 3597-3610
Author(s):  
Paulo Adão de Medeiros ◽  
Artur Rodrigues Fortunato ◽  
Adriana Aparecida da Fonseca Viscardi ◽  
Fabiana Flores Sperandio ◽  
Giovana Zarpellon Mazo

Resumo Como a demanda por instituições de longa permanência para idosos (ILPIs) está aumentando, torna-se relevante para os sistemas de saúde pública discutir o processo de avaliação das condições de saúde dos seus residentes. O presente estudo objetivou identificar instrumentos de medida construídos especificamente para o gerenciamento e o cuidado de residentes idosos, em instituições de longa permanência. Realizou-se uma revisão sistemática segundo as recomendações PRISMA, nos bancos de dados Medline e CINAHL, desde a sua criação até maio de 2013, utilizando termos da Medical Subject Headings adequados para a busca. Foram encontrados 1858 artigos e selecionados 30, sendo identificados 28 instrumentos nesses estudos. Os EUA foram o país que mais construiu instrumentos voltados a essa população e o Minimum Data Set/Resident Assessment Instrument (MDS/RAI) foi o mais utilizado nos estudos da presente revisão. As variáveis mais frequentemente avaliadas pelos instrumentos foram a depressão, a cognição e a capacidade funcional. Torna-se urgente a reformulação de políticas públicas que garantam um sistema de avaliação padronizado dos residentes de ILPIs no Brasil, sendo um desafio fazer com que os instrumentos desenvolvidos consigam se difundir e se efetivar no cotidiano dos profissionais dessas instituições.


2018 ◽  
Author(s):  
Yang Yang ◽  
John P Hirdes ◽  
Joel A Dubin ◽  
Joon Lee

BACKGROUND  Little is known about whether off-the-shelf wearable sensor data can contribute to fall risk classification or complement clinical assessment tools such as the Resident Assessment Instrument-Home Care (RAI-HC). OBJECTIVE  This study aimed to (1) investigate the similarities and differences in physical activity (PA), heart rate, and night sleep in a sample of community-dwelling older adults with varying fall histories using a smart wrist-worn device and (2) create and evaluate fall risk classification models based on (i) wearable data, (ii) the RAI-HC, and (iii) the combination of wearable and RAI-HC data. METHODS  A prospective, observational study was conducted among 3 faller groups (G0, G1, G2+) based on the number of previous falls (0, 1, ≥2 falls) in a sample of older community-dwelling adults. Each participant was requested to wear a smart wristband for 7 consecutive days while carrying out day-to-day activities in their normal lives. The wearable and RAI-HC assessment data were analyzed and utilized to create fall risk classification models, with 3 supervised machine learning algorithms: logistic regression, decision tree, and random forest (RF). RESULTS  Of 40 participants aged 65 to 93 years, 16 (40%) had no previous falls, whereas 8 (20%) and 16 (40%) had experienced 1 and multiple (≥2) falls, respectively. Level of PA as measured by average daily steps was significantly different between groups (P=.04). In the 3 faller group classification, RF achieved the best accuracy of 83.8% using both wearable and RAI-HC data, which is 13.5% higher than that of using the RAI-HC data only and 18.9% higher than that of using wearable data exclusively. In discriminating between {G0+G1} and G2+, RF achieved the best area under the receiver operating characteristic curve of 0.894 (overall accuracy of 89.2%) based on wearable and RAI-HC data. Discrimination between G0 and {G1+G2+} did not result in better classification performance than that between {G0+G1} and G2+. CONCLUSIONS  Both wearable data and the RAI-HC assessment can contribute to fall risk classification. All the classification models revealed that RAI-HC outperforms wearable data, and the best performance was achieved with the combination of 2 datasets. Future studies in fall risk assessment should consider using wearable technologies to supplement resident assessment instruments.


2013 ◽  
Vol 1 (5) ◽  
pp. 1-138 ◽  
Author(s):  
J Senior ◽  
K Forsyth ◽  
E Walsh ◽  
K O'Hara ◽  
C Stevenson ◽  
...  

AbstractBackgroundOlder prisoners are the fastest growing subgroup in the English and Welsh prison estate. Existing research highlights that older prisoners have high health and social care needs and that, currently, these needs routinely remain unmet.Objectives(1) To explore the needs of men entering and leaving prison; (2) to describe current provision of services, including integration between health and social care services; and (3) to develop and pilot an intervention for identifying health and social care needs on reception into prison, ensuring that these are systematically addressed during custody.MethodsThe research programme was a mixed-methods study comprising four parts: (1) a study of all prisons in England and Wales housing older adult men, establishing current availability and degree of integration between health and social care services through a national survey and qualitative interviews; (2) establishing the health and social care needs of older men entering prison, including experiences of reception into custody, through structured (n = 100) and semistructured (n = 27) interviews; (3) the development and implementation of an intervention to identify and manage the health, social care and custodial needs of older men entering prison; and (4) exploration of the health and social care needs of older men released from prison into the community through qualitative interviews with older prisoners prior to and following discharge from prison. Descriptive statistics were produced for all quantitative data, and qualitative data were analysed using the constant comparison method.ResultsThe number of older prisoner leads has increased in recent years but they do not all appear always to be active in their roles, nor in receipt of specialist training. Nearly half (44%) of establishments do not have an older prisoner policy. There is a lack of integration between health and social care services because of ambiguity regarding responsibility for older prisoners' social care. The responsible social service may be located a considerable distance from where the prisoner is held; in such instances, local social services do not co-ordinate their care. The most frequent unmet need on prison entry was the provision of information about care and treatment. Release planning for older prisoners was frequently non-existent.LimitationsThe study used a cut-off age of 60 years as the lower limit for the definition of an older prisoner; evidence has emerged that supports a redefinition of that cut-off to 50 years. Our study examined the care provided for men and this should be considered if contemplating using the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) with older women in prison.ConclusionThe OHSCAP, developed as part of this study, provided a feasible and acceptable means of identifying and systematically addressing older prisoners' health and social care needs. Future work will include the conduct of a randomised controlled trial to examine the impact of the OHSCAP in terms of improving a range of outcomes, including economic impact.FundingThe National Institute for Health Research Health Services and Delivery Research programme.


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