A quality improvement intervention to increase palliative care in nursing homes.
A quality improvement intervention to increase palliative care in nursing homes.
复制标题
提高疗养院姑息治疗质量的干预措施。
DOI：
10.1089/jpm.2005.8.576
复制
发表时间：
2005
影响因子：
2.8
通讯作者：
C. Glenn Pickard
中科院分区：
文献类型：
--
作者：
Laura C. Hanson;K. Reynolds;M. Henderson;C. Glenn Pickard
CONTEXT
Death is common in nursing homes, but access to palliative care is limited.
OBJECTIVE
To test whether a quality improvement (QI) intervention in nursing homes increases hospice, pain management, and advance care planning.
DESIGN AND SETTING
The QI intervention was tested in seven nursing homes using a prepoststudy design. Two additional nursing homes served as control sites.
PARTICIPANTS
Nine nursing homes serving 1169 residents.
INTERVENTION
The intervention included recruitment and training of Palliative Care Leadership Teams in each facility, followed by six technical assistance meetings for team members. Hospice providers delivered six educational sessions for all nursing home staff using a structured curriculum. Teams received feedback of performance data on hospice enrollment, pain management, and advance care planning at 0, 3, and 6 months.
MAIN OUTCOME MEASURES
Percentage of residents receiving hospice or palliative services, pain assessment, pain treatment among residents in pain, and documented advance care planning discussions.
RESULTS
Intervention facilities increased hospice enrollment from 4.0% of residents at baseline to 6.8% postintervention (p = .01) and increased pain assessments from 18% to 60% (p < .001). Among resident in pain, orders for nonpharmacologic pain treatments increased from 15% to 35% (p < .001), but pain medication use did not change. Residents with in-depth discussions about end-of-life care increased from 4% to 17% (p < .001). There were no significant changes in control sites.
CONCLUSIONS
A quality improvement intervention was effective in increasing hospice enrollment, pain assessment, nonpharmacologic pain treatment, and advance care planning discussions.
影响因子：
120.7
作者：
OConnor, GT;Plume, SK;Kasper, JF
通讯作者：
Kasper, JF