Observational studyJournal of the American Medical Directors Association2018
Resident Vignettes for Assessing Care Quality in Nursing Homes.
Observational study in Journal of the American Medical Directors Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation strategies to support fall prevention interventions in long-term care facilities for older persons: a systematic review.BMC geriatrics · 2023Pooled it
- Application effect of continuous quality improvement measures on patient satisfaction and quality of life in gynecological nursing.American journal of translational research · 2021Article
- Healthcare practitioner views and experiences of patients self-monitoring blood pressure: a vignette study.BJGP open · 2020Article
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Authors and funding
12 authors.
Funding
Abstract
objectivesValidated process measures that correlate with patient outcomes are needed for research and quality improvement.
designCross-sectional analysis within a cluster-randomized fall prevention study.
settingNursing homes in North Carolina (n = 16).
participantsNursing home staff (n = 541) and residents with 1 or more falls in 6 months (n = 597). MEASUREMENTS: Fall-prevention process measures in 4 categories derived from Assessing Care of Vulnerable Elders quality indicators were measured in 2 ways: (1) chart abstraction; and (2) staff responses to clinical vignettes of hypothetical residents at risk for falls. Recurrent fall rates (falls/resident/year) were measured. The proportion of the total variation in falls rates explained by the scores for each method (chart abstraction or vignette) was calculated using multilevel adjusted models.
resultsChart and vignette measures of comorbidity management were moderately correlated (Pearson correlation coefficient 0.43), whereas other process measure categories had low or negative correlation between the 2 methods (psychoactive medication reduction 0.13, environmental modification -0.42, and exercise/rehabilitation -0.08). Measures of environmental modification and comorbidity management explained a moderate amount of the total variation in recurrent fall fates, vignettes (7%-10% variation explained) were superior to chart abstraction (2%-6% variation explained). Vignette responses from unlicensed staff (nurse aides and rehabilitation aides) explained more variance than registered nurses, licensed practical nurses, or other licensed staff in these categories. Process measures for psychoactive medication reduction and exercise/rehabilitation did not explain any of the variation in fall outcomes. Overall, vignette process measures explained 3.9% and chart abstraction measures explained 0% of the variation in fall outcomes.
conclusionsClinical vignettes completed by nursing home staff had greater association with resident recurrent fall rates than traditional chart abstraction process measures.
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