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The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study).
Hibbert, Peter D; Molloy, Charlotte J; Cameron, Ian D; Gray, Leonard C; Reed, Richard L; Wiles, Louise K; Westbrook, Johanna; Arnolda, Gaston; Bilton, Rebecca; Ash, Ruby; Georgiou, Andrew; Kitson, Alison; Hughes, Clifford F; Gordon, Susan J; Mitchell, Rebecca J; Rapport, Frances; Estabrooks, Carole; Alexander, Gregory L; Vincent, Charles; Edwards, Adrian; Carson-Stevens, Andrew; Wagner, Cordula; McCormack, Brendan; Braithwaite, Jeffrey.
Afiliação
  • Hibbert PD; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia. peter.hibbert@mq.edu.au.
  • Molloy CJ; IIMPACT in Health, Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia. peter.hibbert@mq.edu.au.
  • Cameron ID; South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia. peter.hibbert@mq.edu.au.
  • Gray LC; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Reed RL; IIMPACT in Health, Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia.
  • Wiles LK; South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia.
  • Westbrook J; John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, Faculty of Medicine and Health, University of Sydney, Kolling Institute, Reserve Rd, St Leonards, NSW, 2065, Australia.
  • Arnolda G; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Princess Alexandra Hospital Campus, Woolloongabba, QLD, 4102, Australia.
  • Bilton R; Discipline of General Practice, College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, SA, 5042, Australia.
  • Ash R; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Georgiou A; IIMPACT in Health, Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia.
  • Kitson A; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Hughes CF; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Gordon SJ; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Mitchell RJ; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, SA, 5042, Australia.
  • Rapport F; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Estabrooks C; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Alexander GL; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, SA, 5042, Australia.
  • Vincent C; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Edwards A; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, SA, 5042, Australia.
  • Carson-Stevens A; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • Wagner C; Australian Institute of Health Innovation, Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW, 2109, Australia.
  • McCormack B; Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada.
  • Braithwaite J; Columbia University School of Nursing, 560 W. 168Th, New York, NY, USA.
BMC Med ; 22(1): 22, 2024 01 23.
Article em En | MEDLINE | ID: mdl-38254113
ABSTRACT

BACKGROUND:

This study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) recommendations.

METHODS:

Sixteen conditions/processes of care amendable to estimating evidence-based care at a population level were identified from prevalence data and CPGs. Candidate recommendations (n = 5609) were extracted from 139 CPGs which were converted to indicators. National experts in each condition rated the indicators via the RAND-UCLA Delphi process. For the 16 conditions, 236 evidence-based care indicators were ratified. A multi-stage sampling of LTC facilities and residents was undertaken. Trained aged-care nurses then undertook manual structured record reviews of care delivered between 1 March and 31 May 2021 (our record review period) to assess adherence with the indicators.

RESULTS:

Care received by 294 residents with 27,585 care encounters in 25 LTC facilities was evaluated. Residents received care for one to thirteen separate clinical conditions/processes of care (median = 10, mean = 9.7). Adherence to evidence-based care indicators was estimated at 53.2% (95% CI 48.6, 57.7) ranging from a high of 81.3% (95% CI 75.6, 86.3) for Bladder and Bowel to a low of 12.2% (95% CI 1.6, 36.8) for Depression. Six conditions (skin integrity, end-of-life care, infection, sleep, medication, and depression) had less than 50% adherence with indicators.

CONCLUSIONS:

This is the first study of adherence to evidence-based care for people in LTC using multiple conditions and a standardised method. Vulnerable older people are not receiving evidence-based care for many physical problems, nor care to support their mental health nor for end-of-life care. The six conditions in which adherence with indicators was less than 50% could be the focus of improvement efforts.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Assistência Terminal / Assistência de Longa Duração Tipo de estudo: Guideline / Risk_factors_studies Limite: Aged / Humans País como assunto: Oceania Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Assistência Terminal / Assistência de Longa Duração Tipo de estudo: Guideline / Risk_factors_studies Limite: Aged / Humans País como assunto: Oceania Idioma: En Ano de publicação: 2024 Tipo de documento: Article