Deficiency citations for physical restraint use in nursing homes.
Deficiency citations for physical restraint use in nursing homes.
复制标题
疗养院中身体约束使用的缺陷引用。
DOI：
10.1093/geronb/55.1.s33
复制
发表时间：
2000
期刊：
影响因子：
--
通讯作者：
N. G. Castle
中科院分区：
文献类型：
--
作者：
N. G. Castle
目标
被限制在疗养院的居民的平均比例约为20%。不符合卫生保健融资管理局限制使用标准的设施可能会被发出缺陷引用。本文探讨了养老院的结构和过程因素与约束使用的不足引用。
方法
全国代表性的数据，从1997年在线调查认证的自动化记录，首先，提供描述性分析，其次，逻辑回归分析的结构和过程因素与约束使用的缺陷引用。
结果
共有2，321个设施被发现至少有一个约束缺陷，14，703个没有。在控制了其他七个关键变量后，有五个结构因素和六个过程因素是显著的。结构性因素-较大的床位大小，以营利为目的的所有权，和医院为基础-显着相关的限制使用的缺陷引用的可能性较高，而全职同等专科医生每居民和护士助理培训的人数较高，显着相关的可能性较低。过程因素-抽吸治疗，疼痛管理和膀胱训练-与约束使用的缺陷引用的可能性较低显着相关;而静脉治疗，导管的使用率较高，身体约束与缺陷引用的可能性较高显着相关。
讨论
这种分析建立了结构和过程之间的联系，以及限制使用的缺陷引用的结果。结构的结果可能有一些实用的监管机构。它们可以用来制定一个具体的方案，以针对最常被发现有不适当的限制使用的设施。该过程的结果可能有一些实用程序的供应商谁可以使用的信息，以目标居民审查不适当的约束使用。
OBJECTIVES
The average percentage of residents restrained in nursing homes is approximately 20%. Facilities that do not meet Health Care Financing Administration standards for restraint use may be issued a deficiency citation. This article investigates which structure and process factors of nursing homes are associated with a deficiency citation for restraint use.
METHODS
Nationally representative data from the 1997 On-line Survey Certification of Automated Records are used, first, to provide descriptive analyses, and second, for logistic regression analyses of structure and process factors associated with a deficiency citation for restraint use.
RESULTS
A total of 2,321 facilities were found to have at least one restraint deficiency citation, and 14,703 had none. After controlling for seven other key variables, five structural factors and six process factors are significant. The structural factors--larger bed size, for-profit ownership, and hospital based--were significantly associated with a higher likelihood of a deficiency citation for restraint use; whereas higher numbers of full-time equivalent specialists per resident and nurse aide training were significantly associated with a lower likelihood. The process factors--suctioning therapy, pain management, and bladder training--were significantly associated with a lower likelihood of a deficiency citation for restraint use; whereas intravenous therapy, higher use of catheters, and physical restraints were significantly associated with a higher likelihood of a deficiency citation.
DISCUSSION
This analysis establishes linkages between structures and processes and the outcome of a deficiency citation for restraint use. The structural results may have some utility for regulators. They could be used to develop a specific program to target facilities most commonly found to have inappropriate restraint use. The process results may have some utility for providers who could use the information to target residents for review of inappropriate restraint use.
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DOI：
10.1093/geront/22.4.429
发表时间：
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影响因子：
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