冰岛养老院的护理质量用最低数据集质量指标衡量：7 年来养老院数据的回顾性分析。

Quality of care in Icelandic nursing homes measured with Minimum Data Set quality indicators: retrospective analysis of nursing home data over 7 years.

机构信息

Department of Health Sciences, Lund University, Lund, Sweden.

出版信息

Int J Nurs Stud. 2012 Nov;49(11):1342-53. doi: 10.1016/j.ijnurstu.2012.06.004. Epub 2012 Jun 30.

DOI:10.1016/j.ijnurstu.2012.06.004

PMID:22749461

Abstract

BACKGROUND

The increasing need for long-term care as well as diminished financial resources may compromise the quality of care of older people. Thus the need for clinically based quality of care monitoring to guide development of long-term services has been pointed out.

OBJECTIVES

The aim of this study was to investigate trends in quality of care during 2003-2009 as reflected in the Minimum Data Set quality indicator outcome in Icelandic nursing homes and to investigate the association of Minimum Data Set quality indicators with residents' health status (health stability, pain, depression and cognitive performance) and functional profile (activities of daily living and social engagement).

DESIGN

Retrospective analysis of nursing home data over 7 years.

METHODS

The sample used for analysis was 11,034 Minimum Data Set assessments of 3694 residents living in Icelandic nursing homes in 2003-2009. Minimum Data Set quality indicators were used to measure quality of care. The chi-square test for trend and multivariate logistic regression were used to analyse the data.

RESULTS

The mean age of residents during the period of the study ranged from 82.3 (SD 9.1) to 85.1 (SD 8.3) and women accounted for from 65.2% to 67.8%. Findings for 16 out of 20 quality indicators indicated a decline in quality of care (p<0.05), although in 12 out of 20 indicators the prevalence was lower than 25%. One quality indicator showed improvement, i.e. for "Bladder and bowel incontinence without a toileting plan" from 17.4% in 2003 decreasing to 11.5% in 2009 (p<0.001). Residents' health and functional status partially explain the increased prevalence of the quality indicators over time.

CONCLUSION

Further developments in quality of care in Icelandic nursing homes need to be monitored as well as the association between residents' health and functional status and the Minimum Data Set quality indicator outcome. The areas of care where the Minimum Data Set quality indicators showed need for improvement included treatment of depression, number of medications, resident activity level and behavioural symptoms.

摘要

背景

随着人们对长期护理的需求不断增加，以及财政资源的减少，老年人的护理质量可能会受到影响。因此，需要基于临床的护理质量监测来指导长期服务的发展。

目的

本研究旨在调查 2003-2009 年期间冰岛养老院中最低数据集中的护理质量指标结果所反映的护理质量趋势，并调查最低数据集中的护理质量指标与居民健康状况（健康稳定性、疼痛、抑郁和认知功能）和功能状况（日常生活活动和社会参与）之间的关系。

设计

对 7 年来养老院数据的回顾性分析。

方法

用于分析的样本是 2003-2009 年居住在冰岛养老院的 3694 名居民的 11034 次最低数据集评估。最低数据集中的质量指标用于衡量护理质量。采用卡方趋势检验和多变量逻辑回归分析数据。

结果

研究期间居民的平均年龄范围为 82.3（标准差 9.1）至 85.1（标准差 8.3），女性占 65.2%至 67.8%。20 个质量指标中的 16 个指标显示护理质量下降（p<0.05），尽管在 20 个指标中有 12 个指标的患病率低于 25%。有一个质量指标显示有所改善，即“无导尿计划的膀胱和肠道失禁”，从 2003 年的 17.4%下降到 2009 年的 11.5%（p<0.001）。居民的健康和功能状况部分解释了随着时间的推移，质量指标的患病率增加。