The Resource Resident safety practices in nursing home settings, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Sandra Simmons, John Schnelle, Jason Slagle, Nila A. Sathe, David Stevenson, Mariu Carlo, Melissa L. McPheeters

Resident safety practices in nursing home settings, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Sandra Simmons, John Schnelle, Jason Slagle, Nila A. Sathe, David Stevenson, Mariu Carlo, Melissa L. McPheeters

Label
Resident safety practices in nursing home settings
Title
Resident safety practices in nursing home settings
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Sandra Simmons, John Schnelle, Jason Slagle, Nila A. Sathe, David Stevenson, Mariu Carlo, Melissa L. McPheeters
Creator
Contributor
Author
Issuing body
Sponsoring body
Subject
Genre
Language
eng
Summary
BACKGROUND: Resident safety issues are common in nursing homes. Relevant literature reports a range of poor clinical outcomes thought to be preventable if specific care processes were consistently implemented. PURPOSE: To describe the state of the science around nursing home safety in order to establish a research agenda for moving the field forward. METHODS: We developed Guiding Questions (GQs) broadly encompassing issues related to resident safety via discussions with Key Informants representing multiple stakeholder groups and expert clinicians and researchers. To address GQs related to identifying and characterizing contextual factors potentially affecting safety issues in the nursing home setting, applicability of hospital-based safety interventions to the nursing home, uptake of safety interventions, and future research areas related to safety in this setting and the overall long-term care landscape (GQs 1, 2, 4), we used input from conversations with Key Informants and conducted targeted literature searches to inform our discussion. To develop a high-level map of relevant evidence (GQ3), we conducted searches of the literature published between 2005 and October 2015 to identify systematic reviews of interventions addressing safety areas in nursing homes. We also searched the published literature for studies of interventions published after the completion of systematic reviews discussed in this brief. FINDINGS: Key safety issues as defined by Agency for Healthcare Research and Quality Common Format criteria are adverse events such as falls, pressure ulcers, infection, and medication errors/adverse drug events, including inappropriate use. Thirty-six recent systematic reviews evaluated nursing home safety-related interventions to address these issues. Evidence is lacking on the degree to which national uptake of efficacious interventions targeting adverse events or factors that may lead to adverse events has occurred, with barriers including staffing costs needed to implement the interventions and low-quality evidence. Little evidence suggests that hospitals have significantly improved safety in many domains that are important to care of nursing home residents, whose vulnerability and complexity make them markedly different from most hospital patients. Future research needs include defining safety in the nursing home context, which differs considerably from that of hospitals. Defining safety must take into account the context of care and the interplay of resident characteristics and needs within the context of staffing and programmatic decisions that are influenced by various payment and regulatory models. Future research should also address understanding the relationship between adherence to quality-of-life and person-centered care standards and incidence of some types of adverse events, overcoming barriers to implementing proven interventions, and improving safety event reporting. Nursing homes must find the balance between preserving person-centeredness and resident autonomy while ensuring safety, quality of care, and quality of life for residents. Overall, safety outcomes per se have not been well studied in nursing homes; however, outcomes associated with quality of care and, in some cases, quality of life have been studied, and those outcomes may be inexorably linked to safety outcomes. These negative outcomes related to (and potentially contributing to) negative safety outcomes include catheter left in bladder and physical restraints, as well as documented conditions, including unintentional weight loss, decline in activities of daily living, fecal/urinary incontinence, depressive symptoms, and pain
Member of
Cataloging source
NLM
http://library.link/vocab/creatorName
Simmons, Sandra
Government publication
federal national government publication
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WX 150.AA1
http://library.link/vocab/relatedWorkOrContributorName
  • United States
  • Vanderbilt Evidence-based Practice Center
  • Effective Health Care Program (U.S.)
Series statement
  • Technical brief
  • AHRQ publication
Series volume
  • number 24
  • no. 16-EHC022-EF
http://library.link/vocab/subjectName
  • Nursing Homes
  • Safety Management
  • Research
  • United States
  • United States
Label
Resident safety practices in nursing home settings, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Sandra Simmons, John Schnelle, Jason Slagle, Nila A. Sathe, David Stevenson, Mariu Carlo, Melissa L. McPheeters
Instantiates
Publication
Copyright
Note
"May 2016."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
  • cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
  • txt
Content type MARC source
rdacontent
Control code
971612638
Extent
1 online resource (various pagings).
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
  • c
Specific material designation
remote
System control number
(OCoLC)971612638
Label
Resident safety practices in nursing home settings, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Sandra Simmons, John Schnelle, Jason Slagle, Nila A. Sathe, David Stevenson, Mariu Carlo, Melissa L. McPheeters
Publication
Copyright
Note
"May 2016."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
  • cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
  • txt
Content type MARC source
rdacontent
Control code
971612638
Extent
1 online resource (various pagings).
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
  • c
Specific material designation
remote
System control number
(OCoLC)971612638

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