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[瑞士养老院的国家质量指标:关于数据可靠性及用户对实用性看法的问卷调查]

[National quality indicators in Swiss nursing homes : Questionnaire survey on data reliability and users' view on the usefulness].

作者信息

Zúñiga Franziska, Blatter Catherine, Wicki Ruth, Simon Michael

机构信息

Pflegewissenschaft, Department Public Health, Universität Basel, Bernoullistraße 28, 4056, Basel, Schweiz.

Universitäre Forschung Pflege/Hebammen, Inselspital, Universitätsspital Bern, Freiburgstrasse, 3010, Bern, Schweiz.

出版信息

Z Gerontol Geriatr. 2019 Dec;52(8):730-736. doi: 10.1007/s00391-019-01583-7. Epub 2019 Jul 11.

Abstract

BACKGROUND

The publication of quality indicators is used internationally to compare the quality of nursing homes and initiate quality improvement processes. From 2019 onwards, Switzerland will nationally measure and subsequently publish the results of six quality indicators on four measurement topics (use of physical restraint measures, malnutrition, polypharmacy, self-assessed and observed pain).

OBJECTIVE

To assess the reliability of data collection as well as the understandability and usability of the newly developed quality indicators from the perspective of healthcare providers.

MATERIAL AND METHODS

An online survey in a convenience sample from 155 Swiss nursing homes was conducted. The participants answered the items used to measure the quality indicators based on five case study examples. They assessed the understandability of the items and the usability of the indicators for internal quality improvement as well as benchmarking with other nursing homes with a 4-point agreement Likert scale.

RESULTS

A total of 303 persons from 127 nursing homes completed the survey. In 4 out of the 5 case studies the rating of more than 90% of the respondents led to a correct classification of the quality indicator. The counting of active ingredients for polypharmacy and the assessment of observed pain proved to be difficult. More than 80% of the respondents found the items understandable. The respondents agreed more with the usability of the quality indicators for internal quality improvement (78-91%) than for external benchmarking (63-79%).

CONCLUSION

The majority of the quality indicators were correctly classified and rated as useful. For polypharmacy, an electronic support for counting the active ingredients is recommended and for the external assessment of pain the use of a validated pain intensity scale.

摘要

背景

质量指标的公布在国际上被用于比较养老院的质量并启动质量改进流程。从2019年起,瑞士将在全国范围内对四个测量主题(身体约束措施的使用、营养不良、多重用药、自我评估和观察到的疼痛)的六项质量指标进行测量并随后公布结果。

目的

从医疗服务提供者的角度评估数据收集的可靠性以及新开发的质量指标的可理解性和可用性。

材料与方法

对来自155家瑞士养老院的便利样本进行了在线调查。参与者根据五个案例研究示例回答了用于测量质量指标的项目。他们使用4点李克特同意量表评估了项目的可理解性以及指标用于内部质量改进和与其他养老院进行基准比较的可用性。

结果

来自127家养老院的303人完成了调查。在5个案例研究中的4个中,超过90%的受访者的评分导致了质量指标的正确分类。多重用药的活性成分计数和观察到的疼痛评估被证明是困难的。超过80%的受访者认为这些项目是可理解的。受访者对质量指标用于内部质量改进的可用性(78 - 91%)的认同度高于用于外部基准比较的可用性(63 - 79%)。

结论

大多数质量指标被正确分类并被评为有用。对于多重用药,建议采用电子支持来计算活性成分,对于疼痛的外部评估,建议使用经过验证的疼痛强度量表。

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