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Table 2 Results of the modified Delphi exercise to identify the most practice sensitive quality indicators *

From: Practice sensitive quality indicators in RAI-MDS 2.0 nursing home data

Quality indicator Rank order of practice sensitive QIs Number of times quality indicator chosen as most practice sensitive to nursing care, physician care, or policy*
Nursing care n (%) Physician care n (%) Policy maker n (%) Total
Pressure ulcer 1 13 (81) 1 (1) 2 (13) 16
Worsening pain 2 11 (69) 4 (25) 1 (1) 16
Physical restraint use 3.5 10 (63) ± 3 (19) 7 (44) 20
Antipsychotic use without psychosis 3.5 5 (31) 13 (81) 3 (19) 21
Indwelling catheter 5 4 (25) 10 (63) 1 (1) 15
Delirium 6 4 (25) 9 (56) 0 13
Declining behavioral symptoms 7 11 (69) 1 (1) 0 12
Urinary tract infections 8.5 10 (63) 2 (13) 2 (13) 14
Late loss ADL decline 8.5 12 (75) 0 0 12
Fallen last 30 days 10 8 (50) 2 (13) 2 (13) 12
Feeding tube 11 2 (13) 12 (75) 4 (25) 18
Decline in mood 12.5 6 (38) 2 (13) 1(1) 9
Unexplained weight loss 12.5 8 (50) 2 (13) 0 10
  1. ADL, activities of daily living; QI, quality indicator.
  2. *Rater sample size = 16 (Physicians = 4; Nurses = 8, Decision/Policy makers = 4).
  3. Where ties occurred during ranking process, the rank values are represented in decimal place form.
  4. Total counts of number of times QIs are seen as most practice sensitive can exceed the total sample size due to double rating.
  5. ±For example, physical restraint use was ranked most sensitive to nursing care by 10/16 raters, to physician care by 3/16 and policy makers by 7/16.
  6. The bold numbers identify the indicators that are either sensitive to Nursing Care, Physician care, or Policy makers.