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BMC Palliative Care

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Open Access 01-12-2018 | Research article

Developing and testing a nursing home end -of -life care chart audit tool

Authors: Genevieve N. Thompson, Susan E. McClement, Nina Labun, Kathleen Klaasen

Published in: BMC Palliative Care | Issue 1/2018

Abstract

Background

Nursing home (NH) administrators need tools to measure the effectiveness of care delivered at the end of life so that they have objective data on which to evaluate current practices, and identify areas of resident care in need of improvement.

Methods

A three-phase mixed methods study was used to develop and test an empirically derived chart audit tool aimed at assessing the care delivered along the entire dying trajectory.

Results

The Auditing Care at the End of Life (ACE) instrument contains 27 questions captured across 6 domains, which are indicative of quality end-of-life care for nursing home residents.

Conclusions

By developing a brief chart audit tool that captures best practices derived from expert consensus and the research literature, NH facilities will be equipped with one means for monitoring and assessing the care delivered to dying residents.

Doupe M, Fransoo R, Chateau D, Dik N, Burchill C, Soodeen R, et al. Population aging and the continuum of older adult care in Manitoba. Winnipeg: Manitoba Centre for Health Policy; 2011. Retrieved from: http://mchp-appserv.cpe.umanitoba.ca/reference/LOC_Report_WEB.pdf. Accessed 27 May 2014

Mitchell SL, Teno JM, Miller SC, Mor V. A national study of the location of death for older persons with dementia. J Am Geriatr Soc. 2005;53(2):299–305.CrossRefPubMed

Temkin-Greener H, Zheng NT, Xing J, Mukamel DB. Site of death among nursing home residents in the United States: changing patterns, 2003–2007. J Am Med Dir Assoc. 2013;14(10):741–8.CrossRefPubMedPubMedCentral

Menec VH, Nowicki S, Blandford A, Veselyuk D. Hospitalizations at the end of life among long-term care residents. J Gerontol A Biol Sci Med Sci. 2009;64(3):395–402.CrossRefPubMed

Allison JJ, Wall TC, Spettell CM, et al. The art and science of chart review. Jt Comm J Qual Improv. 2000;26:115–36.PubMed

Jennings N, Kansal A, O'Reilly G, et al. Time to analgesia for care delivered by nurse practitioners in the emergency department - a retrospective chart audit. Int Emerg Nurs. 2015;23:71–4. https://doi.org/10.1016/j.ienj.2014.07.002.CrossRefPubMed

Ganesh A, Camden M, Lindsay P, et al. The quality of treatment of hyperacute ischemic stroke in Canada: a retrospective chart audit. CMAJ Open. 2014;2:E233–9. https://doi.org/10.9778/cmajo.20140067.CrossRefPubMedPubMedCentral

Purser L, Warfield K, Richardson C. Making pain visible: an audit and review of documentation to improve the use of pain assessment by implementing pain as the fifth vital sign. Pain Manag Nurs. 2014;15:137–42. https://doi.org/10.1016/j.pmn.2012.07.007.CrossRefPubMed

Tsai LY, Li IF, Liu CP, et al. Application of quality audit tools to evaluate care quality received by terminal cancer patients admitted to a palliative care unit. Support Care Cancer. 2008;16:1067–74. https://doi.org/10.1007/s00520-007-0365-1.CrossRefPubMed

10.

Charlton R, Smith G, White D, et al. Audit tools for palliative care services: identification of neglected aspects of care. Am J Hosp Palliat Care. 2002;19:397–402.CrossRefPubMed

11.

Rogers MS, Barclay SI, Todd CJ. Developing the Cambridge palliative audit schedule (CAMPAS): a palliative care audit for primary health care teams. Br J Gen Pract. 1998;48:1224–7.PubMedPubMedCentral

12.

Solloway M, LaFrance S, Bakitas M, et al. A chart review of seven hundred eighty-two deaths in hospitals, nursing homes, and hospice/home care. J Palliat Med. 2005;8:789–96. https://doi.org/10.1089/jpm.2005.8.789.CrossRefPubMed

13.

Hall P, Schroder C, Weaver L. The last 48 hours of life in long-term care: a focused chart audit. J Am Geriatr Soc. 2002;50:501–6.CrossRefPubMed

14.

Dy SM, Kiley KB, Ast K, et al. Measuring what matters: top-ranked quality indicators for hospice and palliative care from the american academy of hospice and palliative medicine and hospice and palliative nurses association. J Pain Symptom Manag. 2015;49:773–81. https://doi.org/10.1016/j.jpainsymman.2015.01.012.CrossRef

15.

Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. New York: Oxford University Press; 2008.CrossRef

16.

Bosek MS, Lowry E, Lindeman DA, et al. Promoting a good death for persons with dementia in nursing facilities: family caregivers’ perspectives. JONAS Healthc Law Ethics Regul. 2003;5:34–41.CrossRefPubMed

17.

Gearing RE, Mian IA, Barber J, et al. A methodology for conducting retrospective chart review research in child and adolescent psychiatry. J Can Acad Child Adolesc Psychiatry. 2006;15:126–34.PubMedPubMedCentral

18.

Banks NJ. Designing medical record abstraction forms. Int J Qual Health Care. 1998;10:163–7.CrossRefPubMed

19.

Worster A, Haines T. Advanced statistics: understanding medical record review (MRR) studies. Acad Emerg Med. 2004;11:187–92.CrossRefPubMed

20.

Eder C, Fullerton J, Benroth R, et al. Pragmatic strategies that enhance the reliability of data abstracted from medical records. Appl Nurs Res. 2005;18:50–4. https://doi.org/10.1016/j.apnr.2004.04.005.CrossRefPubMed

21.

de Vet HC, Mokkink LB, Terwee CB, et al. Clinicians are right not to like Cohen's kappa. BMJ. 2013;346:f2125. https://doi.org/10.1136/bmj.f2125.CrossRefPubMed

22.

Streubert Speziale H, Rinaldi CD. Qualitative research in nursing: advancing the humanistic imperative. 4th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011.

23.

de Souto Barreto P, Lapeyre-Mestre M, Vellas B, et al. Potential underuse of analgesics for recognized pain in nursing home residents with dementia: a cross-sectional study. Pain. 2013;154:2427–31. https://doi.org/10.1016/j.pain.2013.07.017.CrossRefPubMed

24.

Lin WC, Lum TY, Mehr DR, et al. Measuring pain presence and intensity in nursing home residents. J Am Med Dir Assoc. 2006;7:147–53. https://doi.org/10.1016/j.jamda.2005.08.005.CrossRefPubMed

25.

Monroe TB, Misra SK, Habermann RC, et al. Pain reports and pain medication treatment in nursing home residents with and without dementia. Geriatr Gerontol Int. 2014;14:541–8. https://doi.org/10.1111/ggi.12130.CrossRefPubMed

26.

Teno JM, Kabumoto G, Wetle T, et al. Daily pain that was excruciating at some time in the previous week: prevalence, characteristics, and outcomes in nursing home residents. J Am Geriatr Soc. 2004;52:762–7. https://doi.org/10.1111/j.1532-5415.2004.52215.x.CrossRefPubMed

27.

Sawyer P, Lillis JP, Bodner EV, et al. Substantial daily pain among nursing home residents. J Am Med Dir Assoc. 2007;8:158–65. https://doi.org/10.1016/j.jamda.2006.12.030.CrossRefPubMed

28.

Coker E, Papaioannou A, Turpie I, et al. Pain management practices with older adults on acute medical units. Perspectives. 2008;32:5–12.PubMed

29.

Samuels JG, Fetzer S. Pain management documentation quality as a reflection of nurses’ clinical judgment. J Nurs Care Qual. 2009;24:223–31. https://doi.org/10.1097/NCQ.0b013e318194fcec.CrossRefPubMed

30.

Wang N, Hailey D, Yu P. Quality of nursing documentation and approaches to its evaluation: a mixed-method systematic review. J Adv Nurs. 2011;67:1858–75. https://doi.org/10.1111/j.1365-2648.2011.05634.x.CrossRefPubMed

31.

Prideaux A. Issues in nursing documentation and record-keeping practice. Br J Nurs. 2011;20:1450–4. https://doi.org/10.12968/bjon.2011.20.22.1450.CrossRefPubMed

32.

Jefferies D, Johnson M, Griffiths R. A meta-study of the essentials of quality nursing documentation. Int J Nurs Pract. 2010;16:112–24. https://doi.org/10.1111/j.1440-172X.2009.01815.x.CrossRefPubMed

33.

Larson J, Bjorvell C, Billing E, et al. Testing of an audit instrument for the nursing discharge note in the patient record. Scand J Caring Sci. 2004;18:318–24. https://doi.org/10.1111/j.1471-6712.2004.00288.x.CrossRefPubMed

Title: Developing and testing a nursing home end -of -life care chart audit tool
Authors: Genevieve N. Thompson
Susan E. McClement
Nina Labun
Kathleen Klaasen
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Palliative Care / Issue 1/2018
Electronic ISSN: 1472-684X
DOI: https://doi.org/10.1186/s12904-018-0301-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Developing and testing a nursing home end -of -life care chart audit tool

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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