Quality of care in a Veterans Affairs' nursing home-based hospice unit.

Objectives: To report on quality of care in a Veterans Affairs (VA) dedicated hospice unit.

Design: Mortality follow-back survey of bereaved family members, using a quality of care instrument.

Setting: A VA inpatient hospice unit.

The effects of changes in nursing home staffing on pressure ulcer rates.

Objective: To examine the relationships between various components of nursing home staffing (total staffing levels and staff mix, staff turnover, and changes in staffing patterns) to an important measure of quality, risk-adjusted rates of pressure ulcer development. DESIGN, SETTING, AND MEASUREMENTS: Staffing records from 35 Department of Veterans Affairs (DVA) nursing homes were reviewed and nursing home administrators from each of the facilities were interviewed. Incidence rates for pressure ulcers were obtained from DVA's national long-term care database and risk adjusted using patients' baseline characteristics.

Quality improvement implementation in the nursing home.

Objective: To examine quality improvement (QI) implementation in nursing homes, its association with organizational culture, and its effects on pressure ulcer care.

Data Sources/study Setting: Primary data were collected from staff at 35 nursing homes maintained by the Department of Veterans Affairs (VA) on measures related to QI implementation and organizational culture. These data were combined with information obtained from abstractions of medical records and analyses of an existing database.

Adherence to pressure ulcer prevention guidelines: implications for nursing home quality.

Objectives: This study aims to assess overall nursing home (NH) implementation of pressure ulcer (PU) prevention guidelines and variation in implementation rates among a geographically diverse sample of NHs.

Design: Review of NH medical records.

Setting: A geographically diverse sample of 35 Veterans Health Administration NHs.