A commitment to change: Revision of HCFA's RAI
A commitment to change: Revision of HCFA's RAI
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DOI：
10.1111/j.1532-5415.1997.tb02974.x
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发表时间：
1997-08-01
影响因子：
6.3
通讯作者：
Phillips, C
中科院分区：
文献类型：
--
作者：
Morris, JN;Nonemaker, S;Phillips, C
目的：根据住院医师评估工具（RAI）2.0版的现场测试结果，描述新评估项目的可靠性及其临床实用性，由经验丰富的护士评估员进行判断。设计：由护理人员使用最小数据集（MDS）2.0版草案对护理机构的住院医师进行独立的双重评估。从7个州的21家养老院随机选择的187名居民自愿测试MDS 2.0版。测量：MDS评估项目的完整阵列包括以下方面的措施：背景信息，认知模式，沟通/听力，视力，情绪和行为，心理健康，身体功能和结构问题，疾病诊断，健康状况，口腔/营养状况，牙齿状况，皮肤状况，活动追求模式，药物，特殊治疗和程序，放电潜力和整体status.RESULTS：评估数据解决MDS项目效用和可靠性的问题。对于新的项目，几乎所有达到了合理的高加权Kappa评分者间的可靠性;修订的项目也超过了早期的项目，并与更新的培训材料，即使是不变的项目有更高的平均可靠性水平。基于成功的现场测试和积极响应的行业，版本2.0的RAI已被通过，和HCFA已经启动了一个更长远的过程，以进一步更新RAI在necessary.CONCLUSION：调查结果支持的可靠性和临床效用的新的和修订的评估项目纳入HCFA在版本2.0的MDS。
OBJECTIVE: To describe the reliability of new assessment items and their clinical utility as judged by experienced nurse assessors, based on the results from the field test of Version 2.0 of the Resident Assessment Instrument (RAI).DESIGN: Independent dual assessment of residents of nursing facilities by staff nurses using a draft of Version 2.0 of the minimum data set (MDS).SETTING AND PARTICIPANTS: A total of 187 randomly selected residents from 21 nursing homes in seven states volunteered to test Version 2.0 of the MDS.MEASUREMENT: The full array of MDS assessment items included measures in the following areas: Background information, cognitive patterns, communication/hearing, vision, mood and behavior, psychosocial well-being, physical functioning and structural problems, continence, disease diagnoses, health condition, oral/nutritional status, dental status, skin condition, activity pursuit patterns, medications, special treatments and procedures, and discharge potential and overall status.RESULTS: Evaluative data address issues of MDS item utility and reliability. For new items, almost all achieved a reasonably high-weighted Kappa interrater reliability; revised items also surpassed earlier items, and with the updated training materials, even the non-changed items had higher average reliability levels. Based on the success of the field test and the positive response of the industry, Version 2.0 of the RAI has been adopted, and HCFA has initiated a more long-range process to update further the RAI when necessary.CONCLUSION: Findings support the reliability and clinical utility of the new and revised assessment items incorporated by HCFA in Version 2.0 of the MDS.