End-of-life care in nursing home settings: do race or age matter?

Objective: One-quarter of all U.S. chronic-disease deaths occur in nursing homes, yet few studies examine palliative care quality in these settings.

Disparities in pain management between cognitively intact and cognitively impaired nursing home residents.

This study tests the association between residents' cognitive impairment and nursing homes' pain management practices. We used chart abstraction to collect data on 551 adults in six North Carolina nursing homes. From the standard data collected in the Minimum Data Set, 24% of residents experienced pain in the preceding week.

Using quality improvement to address pain management practices in nursing homes.

The objective of this study was to test whether a quality improvement intervention can improve pain management in nursing homes. Experts in quality improvement and clinical pain management provided nursing home staff leaders with feedback on pain quality indicator data, education in pain management, and technical assistance to apply the Plan-Do-Study-Act model of quality improvement. Trained abstractors completed structured chart audits at baseline and five months to capture quality indicator data related to pain assessment and treatment.

A quality improvement intervention to increase palliative care in nursing homes.

Context: Death is common in nursing homes, but access to palliative care is limited.

Objective: To test whether a quality improvement (QI) intervention in nursing homes increases hospice, pain management, and advance care planning.

Design And Setting: The QI intervention was tested in seven nursing homes using a prepoststudy design.