Structural quality indicators to support quality of care for older people with cognitive impairment in emergency departments
Schnitker, Linda M., Martin-Khan, Melinda, Burkett, Ellen, Brand, Caroline A., Beattie, Elizabeth R.A., Jones, Richard N., Gray, Len C., & Carpenter, Christopher R. (2015) Structural quality indicators to support quality of care for older people with cognitive impairment in emergency departments. Academic Emergency Medicine, 22(3), pp. 273-284.
The purpose of this study was to identify the structural quality of care domains and to establish a set of structural quality indicators (SQIs) for the assessment of care of older people with cognitive impairment in emergency departments (EDs).
A structured approach to SQI development was undertaken including:
1) a comprehensive search of peer-reviewed and gray literature focusing on identification of evidence-based interventions targeting structure of care of older patients with cognitive impairment and existing SQIs;
2) a consultative process engaging experts in the care of older people and epidemiologic methods (i.e., advisory panel) leading to development of a draft set of SQIs;
3) field testing of drafted SQIs in eight EDs, leading to refinement of the SQI set, and;
4) an independent voting process among the panelists for SQI inclusion in a final set, using preestablished inclusion and exclusion criteria.
At the conclusion of the process, five SQIs targeting the management of older ED patients with cognitive impairment were developed:
1) the ED has a policy outlining the management of older people with cognitive impairment during the ED episode of care;
2) the ED has a policy outlining issues relevant to carers of older people with cognitive impairment, encompassing the need to include the (family) carer in the ED episode of care;
3) the ED has a policy outlining the assessment and management of behavioral symptoms, with specific reference to older people with cognitive impairment;
4) the ED has a policy outlining delirium prevention strategies, including the assessment of patients' delirium risk factors, and;
5) the ED has a policy outlining pain assessment and management for older people with cognitive impairment.
This article presents a set of SQIs for the evaluation of performance in caring for older people with cognitive impairment in EDs.
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|Item Type:||Journal Article|
|Keywords:||behavior disorder, structural quality indicator, risk factor, priority journal, peer review, caregiver, clinical indicator, cognitive defect, delirium, elderly care, emergency care, emergency ward, evidence based practice, health care quality, pain assessment, human|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)|
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
|Copyright Owner:||Copyright 2015 by the Society for Academic Emergency Medicine|
|Deposited On:||12 May 2015 23:16|
|Last Modified:||20 May 2015 05:14|
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