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| Refine an instrument to measure "Observable Indicators of Nursing Home Care Quality" (NINR-funded) |
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Based on the focus groups of providers and consumers of nursing home care measurable statements from participants for each dimension were combined with likert scales to construct an instrument to be used to observe and score care quality in a nursing home following 20-30 minute observation.
Several revisions and pilot tests resulted in a 29 item instrument with index of content validity of 9.1 (4 experts), test reliability of 0.84 (n=21)and interrater reliability of 0.79 (n=30) for total score (60 homes). Chronbach alpha calculations for each subscale range from 0.77 to 0.93 and 0.96 for the total score (n=109). Testing in a sample of 11 Icelandic nursing homes was completed. The instrument is an independent observable measure of nursing home care quality to use in combination with MDS quality indicators and other measures. The "Observable Indicators of Quality" instrument was revised again based on the results of consumer focus groups. This Version 5 instrument has 42 items and is being field tested in an NINR funded study underway at this time in three states (Rantz and Zwygart-Stauffacher). Version 5 and a residential care version of the instrument are being used in the Quality Improvement Program for Missouri Long Term Care project. Aud, M.A., Rantz, M.J., Zwygart-Stauffacher, M., & Manion, P. (2004). Developing a residential care facility version of the observable indicators of nursing home care quality instrument. Journal of Nursing Care Quality, 19(1): 48-57. Rantz, M., Jensdottir, A.B., Hjaltadottir, I., Gudmundsdottir, H., Sigurveig Gudjonsdottir, J., Brunton, B., and Rook, M. (2002). International field test results of the observable indicators of nursing home care quality instrument. International Nursing Review, 49(4): 234-242. Rantz, M.J. & Mehr, D.R. (2001) A quest to understand and measure nursing home quality of care. Long-Term Care Interface, 2(7): 34-38. Rantz, M.J., Mehr,D.R., Petroksi, G.F., Madsen, R.W., Popejoy, L., Hicks, L.L., Conn, V.S., Grando, V.T., Wipke-Tevis, D.D., Bostick, J., Porter, R., Zwygart-Stauffacher, M., & Maas, M. (2000) Initial field-testing of an instrument to measure "Observable indicators of nursing home care quality." Journal of Nursing Care Quality, 14(3), 1-12. |