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

BMC Research Notes

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

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^*
Quality indicator	Rank order of practice sensitive QIs^†	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

ADL, activities of daily living; QI, quality indicator.
^*Rater sample size = 16 (Physicians = 4; Nurses = 8, Decision/Policy makers = 4).
^†Where ties occurred during ranking process, the rank values are represented in decimal place form.
^‡Total counts of number of times QIs are seen as most practice sensitive can exceed the total sample size due to double rating.
^±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.
The bold numbers identify the indicators that are either sensitive to Nursing Care, Physician care, or Policy makers.

ISSN: 1756-0500