The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study).
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.Palavras-chave
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