The Minimum Data Set weight-loss quality indicator: Does it reflect differences in care processes related to weight loss?
The Minimum Data Set weight-loss quality indicator: Does it reflect differences in care processes related to weight loss?
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DOI：
10.1046/j.1532-5415.2003.51459.x
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发表时间：
2003-10-01
影响因子：
6.3
通讯作者：
Schnelle, JF
中科院分区：
文献类型：
--
作者：
Simmons, SF;Garcia, ET;Schnelle, JF
目的：根据最小数据集（MDS）质量指标，确定是否护理之家（NH）对体重减轻的流行程度评分不同，也提供与体重减轻相关的不同护理过程。11个国家卫生机构在下一级（第25次调查-低患病率）四分位数和五个高患病率国家（第75次调查-高患病率）MDS减肥质量指标的四分位数。参与者：400名长期居民。经过培训的研究人员在连续三天12小时（上午7时至下午7时）的评估期间对NH工作人员实施每个护理流程的情况进行了测量，其中包括直接观察期间用餐，居民访谈，并使用标准化protocols.Results的医疗记录抽象：体重减轻的患病率是显着高于参与者在上四分位数的NHS比参与者在下四分位数的NHS的MDS和每月的体重数据记录在医疗记录。体重减轻流行率较高的NHS有明显更大比例的居民有体重减轻的危险因素，即低口服食物和液体摄入量。低体重和高体重减肥的护理人员在护理过程中的措施几乎没有显着差异。工作人员在低体重损失NHs一贯提供口头提示和社会交往在用餐期间，以更大比例的居民，包括那些最有风险的weight loss.CONCLUSION：MDS减肥质量指标反映了NHs之间的体重减轻的患病率的差异。体重减轻发生率较低的国家卫生机构有较少的居民体重减轻的风险，工作人员在用餐期间向更多的居民提供口头提示和社会互动，但所有国家卫生机构的喂养援助护理的充分性和质量需要改进。
OBJECTIVES: To determine whether nursing homes (NHs) that score differently on prevalence of weight loss, according to a Minimum Data Set (MDS) quality indicator, also provide different processes of care related to weight loss.DESIGN: Cross-sectional.SETTING: Sixteen skilled nursing facilities: 11 NHs in the lower (25th percentile-low prevalence) quartile and five NHs in the upper (75th percentile-high prevalence) quartile on the MDS weight-loss quality indicator.PARTICIPANTS: Four hundred long-term residents.MEASUREMENTS: Sixteen care processes related to weight loss were defined and operationalized into clinical indicators. Trained research staff conducted measurement of NH staff implementation of each care process during assessments on three consecutive 12-hour days (7 a.m. to 7 p.m.), which included direct observations during meals, resident interviews, and medical record abstraction using standardized protocols.RESULTS: The prevalence of weight loss was significantly higher in the participants in the upper quartile NHs than in participants in the lower quartile NHs based on MDS and monthly weight data documented in the medical record. NHs with a higher prevalence of weight loss had a significantly larger proportion of residents with risk factors for weight loss, namely low oral food and fluid intake. There were few significant differences on care process measures between low- and high-weight-loss NHs. Staff in low-weight-loss NHs consistently provided verbal prompting and social interaction during meals to a greater proportion of residents, including those most at risk for weight loss.CONCLUSION: The MDS weight-loss quality indicator reflects differences in the prevalence of weight loss between NHs. NHs with a lower prevalence of weight loss have fewer residents at risk for weight loss and staff who provide verbal prompting and social interaction to more residents during meals, but the adequacy and quality of feeding assistance care needs improvement in all NHs.