ArticleJournal of the American Geriatrics Society2016
Longitudinal Pressure Ulcer Rates After Adoption of Culture Change in Veterans Health Administration Nursing Homes.
Article in Journal of the American Geriatrics Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
5 citing papers in PubMed.
- Detection and classification methodology for movements in the bed that supports continuous pressure injury risk assessment and repositioning compliance.Journal of tissue viability · 2019Article
- A Longitudinal Assessment of the Effect of Resident-Centered Care on Quality in Veterans Health Administration Community Living Centers.Health services research · 2018Article
- Subepidermal moisture detection of pressure induced tissue damage on the trunk: The pressure ulcer detection study outcomes.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society · 2017Article
- Contextual Facilitators of and Barriers to Nursing Home Pressure Ulcer Prevention.Advances in skin & wound care · 2016Article
- Is Variation in Resident-Centered Care and Quality Performance Related to Health System Factors in Veterans Health Administration Nursing Homes?Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo examine facility-level pressure ulcer (PrU) development rates and variations in these rates after a system-wide adoption of culture change in Veterans Health Administration (VHA) nursing homes.
designFour-year retrospective longitudinal design.
settingVHA facilities (N=109) representing 132 nursing homes known as community living centers (CLCs).
participantsVHA nursing home residents. MEASUREMENTS: PrUs were identified using fiscal year (FY) 2008-11 Minimum Data Set (MDS) data. PrU development was defined as a Stage 2 or larger PrU on an MDS assessment with no PrU on the previous assessment. A risk adjustment model was developed using 105,274 MDS observations to predict the likelihood of PrUs (c-statistic=0.72). A Bayesian hierarchical model that adjusted for differences in the precision of PrU rates from different-size facilities was used to calculate smoothed risk-adjusted (SRA) rates for each facility. The statistical significance of the trend over the 4 years was determined by examining the 95% interval estimate for the slope.
resultsOver the 4-year period, the beginning of which coincided with the VHA's system-wide adoption of culture change as a performance measure, median SRA facility PrU development rates were fairly consistent at approximately 4%. The range in SRA rates declined over the years, from a 14.8-percentage point spread to 10.1-percentage point spread. Some facilities had significantly improving SRA rates (e.g., declined steadily from 5.5% to 3.9%) and some had significantly worsening SRA rates (e.g., increased steadily from 5.1% to 7.9%). Seven sites had significantly improving rates (P<.001) that were below the median across all 4 years.
conclusionA system-wide culture change implementation did not affect CLC PrU development rates, but there was significant variation in facility rates, and some facilities had sustained high performance.
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