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Defining Safety in the Nursing Home Setting: Implications for Future Research.

Abstract：

:Currently, the Agency for Healthcare Research and Quality (AHRQ) Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to safety in the NH setting to inform a research agenda. Thirty-six recent systematic reviews evaluated NH safety-related interventions to address these 4 adverse events and reported mostly mixed evidence about effective approaches to ameliorate them. Furthermore, these 4 events are likely inadequate to capture safety issues that are unique to the NH setting and encompass other domains related to residents' quality of care and quality of life. Future research needs include expanding our definition of safety in the NH setting, which differs considerably from that of hospitals, to include contributing factors to adverse events as well as more resident-centered care measures. Second, future research should reflect more rigorous implementation science to include objective measures of care processes related to adverse events, intervention fidelity, and staffing resources for intervention implementation to inform broader uptake of efficacious interventions. Weaknesses in implementation contribute to the current inconclusive and mixed evidence base as well as remaining questions about what outcomes are even achievable in the NH setting, given the complexity of most resident populations. Also related to implementation, future research should determine the effects of specific staffing models on care processes related to safety outcomes. Last, future efforts should explore the potential for safety issues in other care settings for older adults, most notably dementia care within assisted living.

journal_name

J Am Med Dir Assoc

journal_title

Journal of the American Medical Directors Association

authors

Simmons SF,Schnelle JF,Sathe NA,Slagle JM,Stevenson DG,Carlo ME,McPheeters ML

doi

10.1016/j.jamda.2016.03.005

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

473-81

issue

eissn

1525-8610

issn

1538-9375

pii

S1525-8610(16)30035-4

journal_volume

pub_type

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Defining Safety in the Nursing Home Setting: Implications for Future Research.