RESUMO
This article reports on a survey of opinions about specific categories and indicators of quality used by the Health Care Financing Administration in the survey and certification process for nursing homes in the US. The survey was conducted of a selected sample of administrators, directors of nursing, state survey agency training coordinators, state ombudsmen, and nursing home advocates in 1996. General patterns of agreement were found across all respondent groups that the 3 most important categories of quality were as follows: quality of care, quality of life, and residents' rights. The 3 most important quality-of-care survey items were as follows: general quality of care, maintenance of activities of daily living, and appropriate treatment for impairment in activities of daily living. The 3 most important quality-of-life items were as follows: dignity, self-determination and participation, and accommodation of resident needs. Important residents' rights items were as follows: to be able to exercise general rights, to be informed of one's condition, and to be free of reprisal when making complaints. Quality assurance should focus greater attention on the areas considered to be the most important by the various stakeholders in nursing home care.
Assuntos
Comportamento do Consumidor/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/normas , Casas de Saúde/normas , Indicadores de Qualidade em Assistência à Saúde , Idoso , Centers for Medicare and Medicaid Services, U.S. , Humanos , Defesa do Paciente , Qualidade da Assistência à Saúde , Qualidade de Vida , Estados UnidosRESUMO
Individualized care for frail elders is defined as an interdisciplinary approach which acknowledges elders as unique persons and is practiced through consistent caring relationships. The four critical attributes of individualized care for frail elders are: 1) knowing the person, 2) relationship, 3) choice, and 4) participation in and direction of care. Cognitively impaired elders can direct their care through the staff's knowledge of individual past patterns and careful observation of behavior for what is pleasing and comfortable to each resident.
Assuntos
Idoso Fragilizado , Enfermagem Geriátrica , Teoria de Enfermagem , Planejamento de Assistência ao Paciente , Idoso , Humanos , Relações Enfermeiro-Paciente , Participação do Paciente , Qualidade de VidaRESUMO
Facilities can become free of physical restraints, as many providers have learned. They can also become chemically restraint free, even though psychoactive drugs are used for some residents.