Field testing, refinement, and psychometric evaluation of a new measure of nursing home care quality.

The primary aim of this NINR-NIH-funded field test in 407 nursing homes in 3 states was to complete the development of and conduct psychometric testing for the Observable Indicators of Nursing Home Care Quality Instrument (Observable Indicators, OIQ). The development of the OIQ was based on extensive qualitative and iterative quantitative work that described nursing home care quality and did initial validity and reliability field testing of the instrument in 123 nursing homes in 1 state. The scale is meant for researchers, consumers, and regulators interested in directly observing and quickly evaluating (within 30 minutes of observation) the multiple dimensions of care quality in nursing homes.

Systematic review of studies of staffing and quality in nursing homes.

Purpose: To evaluate a range of staffing measures and data sources for long-term use in public reporting of staffing as a quality measure in nursing homes.

Method: Eighty-seven research articles and government documents published from 1975 to 2003 were reviewed and summarized. Relevant content was extracted and organized around 3 themes: staffing measures, quality measures, and risk adjustment variables.

Introducing baccalaureate student nurses to gerontological nursing.

The faculty at the University of Missouri-Columbia Sinclair School of Nursing (MUSSON) developed and implemented a gerontological nursing care course, with support from the Health Resources and Services Administration, the American Association of Colleges of Nursing, and the John A. Hartford Foundation. The course, with both didactic and clinical components, was mandatory for all students in the baccalaureate program.

Relationship of nursing personnel and nursing home care quality.

The purpose of this study was to examine the associations between nurse staffing hours and 6 quality indicators: physical restraints, weight loss, incontinence, late loss activities of daily living decline, stages 1 to 4 pressure ulcers, and problem behaviors toward others. Increasing registered nurse staff hours may achieve better quality indicator scores for pressure ulcers. An increase in nurse aide hours should be carefully weighed with the amount of registered nurse staff time available for supervision and direction.

Nursing home quality, cost, staffing, and staff mix.

Purpose: The purpose of this study was to describe the processes of care, organizational attributes, cost of care, staffing level, and staff mix in a sample of Missouri homes with good, average, and poor resident outcomes.

Design And Methods: A three-group exploratory study design was used, with 92 nursing homes randomly selected from all nursing homes in Missouri and classified into resident outcome groups. Resident outcomes were measured by use of quality indicators derived from nursing home Minimum Data Set resident assessment data.

Quality measurement in nursing: an update of where we are now.

This article summarizes the findings of the third review of nursing quality measurement literature commissioned by the American Nurses' Association, discusses implications of the current state of the art of nursing measurement, and suggests directions based upon lessons learned from all 3 reviews. Using both computer and hand searching methods, 326 articles describing measurement of nursing care quality were abstracted. Recommendations based on the analysis of Literature include incorporating the Nursing Minimum Data Set into databases; documenting nursing hours and nursing educational preparation; determining appropriate patient outcomes within different settings; continued research identifying nurse-sensitive outcomes; and continued nursing leadership in quality improvement efforts for health care.