《澳大利亚老年人登记处成果监测系统：养老机构的质量和安全指标》。

The Registry of Senior Australians outcome monitoring system: quality and safety indicators for residential aged care.

机构信息

Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia.

Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia.

出版信息

Int J Qual Health Care. 2020 Nov 9;32(8):502-510. doi: 10.1093/intqhc/mzaa078.

DOI:10.1093/intqhc/mzaa078

PMID:32696038

Abstract

OBJECTIVES

To introduce the Registry of Senior Australians (ROSA) Outcome Monitoring System, which can monitor the quality and safety of care provided to individuals accessing residential aged care. Development and examination of 12 quality and safety indicators of care and their 2016 prevalence estimates are presented.

DESIGN

Retrospective.

SETTING

2690 national and 254 South Australian (SA) aged care facilities.

PARTICIPANTS

208 355 unique residents nationally and 18 956 in SA.

MAIN OUTCOME MEASURES

Risk-adjusted prevalence of high sedative load, antipsychotic use, chronic opioid use, antibiotic use, premature mortality, falls, fractures, medication-related adverse events, weight loss/malnutrition, delirium and/or dementia hospitalisations, emergency department presentations, and pressure injuries.

RESULTS

Five indicators were estimated nationally; antibiotic use (67.5%, 95% confidence interval (CI): 67.3-67.7%) had the highest prevalence, followed by high sedative load (48.1%, 95% CI: 47.9-48.3%), chronic opioid use (26.8%, 95% CI: 26.6-26.9%), antipsychotic use (23.5%, 95% CI: 23.4-23.7%) and premature mortality (0.6%, 95% CI: 0.6-0.7%). Seven indicators were estimated in SA; emergency department presentations (19.1%, 95% CI: 18.3-20.0%) had the highest prevalence, followed by falls (10.1%, 95% CI: 9.7-10.4%), fractures (4.8%, 95% CI: 4.6-5.1%), pressure injuries (2.9%, 95% CI: 2.7-3.1%), delirium and/or dementia related hospitalisations (2.3%, 95% CI: 2.1-2.6%), weight loss/malnutrition (0.7%, 95% CI: 0.6-0.8%) and medication-related events (0.6%, 95% CI: 0.5-0.7%).

CONCLUSIONS

Twelve quality and safety indicators were developed to monitor aged care provided to older Australians based on the synthesis of existing literature and expert advisory input. These indicators rely on existing data within the aged care and healthcare sectors, therefore creating a pragmatic tool to examine quality and unwarranted care variation.

摘要

目的

介绍澳大利亚老年人登记处（ROSA）结果监测系统，该系统可监测为入住养老院的个人提供的护理的质量和安全性。本文介绍了护理质量和安全的 12 项指标及其 2016 年的流行率预估，并对其进行了开发和检验。

设计

回顾性研究。

地点

全国 2690 家和南澳大利亚州（SA）254 家养老院。

参与者

全国有 208355 名独特居民，SA 有 18956 名。

主要观察指标

高镇静负荷、抗精神病药物使用、慢性阿片类药物使用、抗生素使用、过早死亡率、跌倒、骨折、药物相关不良事件、体重减轻/营养不良、谵妄和/或痴呆住院、急诊科就诊和压力性损伤的风险调整后流行率。

结果

全国有 5 项指标被估算；抗生素使用率（67.5%，95%置信区间[CI]：67.3-67.7%）最高，其次是高镇静负荷（48.1%，95%CI：47.9-48.3%）、慢性阿片类药物使用（26.8%，95%CI：26.6-26.9%）、抗精神病药物使用（23.5%，95%CI：23.4-23.7%）和过早死亡率（0.6%，95%CI：0.6-0.7%）。在 SA 有 7 项指标被估算；急诊科就诊率（19.1%，95%CI：18.3-20.0%）最高，其次是跌倒（10.1%，95%CI：9.7-10.4%）、骨折（4.8%，95%CI：4.6-5.1%）、压力性损伤（2.9%，95%CI：2.7-3.1%）、谵妄和/或痴呆相关住院率（2.3%，95%CI：2.1-2.6%）、体重减轻/营养不良率（0.7%，95%CI：0.6-0.8%）和药物相关事件发生率（0.6%，95%CI：0.5-0.7%）。