From: The calculation of quality indicators for long term care facilities in 8 countries (SHELTER project)
# 1 | Indicator | Numerator 2 | Denominator exclusions 3 | Risk adjustment | FAP 4 |
---|---|---|---|---|---|
Prevalence indicators | |||||
Mental functions | |||||
beh01 | Behaviour problem prevalence 5 | Behaviour symptoms | Comatose. | + | |
beh02 | High risk behaviour problem prevalence | Behaviour symptoms | Comatose. | + | |
Low risk behaviour (see beh03) | |||||
beh03 | Low risk behaviour problem prevalence | Behaviour symptoms | Comatose. | + | |
Dependent in daily decision making or short term memory problem. Schizophrenic or bipolar depression. | |||||
dep01 | Depression prevalence | Depression Ration Scale score > = 3 | |||
Health problems | |||||
cnt01 | Bladder/bowel incontinence prevalence | Frequent or always bladder or bowel incontinent | Comatose, end-stage disease or hospice care. | + | |
cnt05 | High risk bladder/bowel incontinence prevalence | Frequent or always bladder or bowel incontinent | Comatose, end-stage disease or hospice care. | + | |
Low risk incontinence (see cnt06) | |||||
cnt06 | Low risk bladder/bowel incontinence prevalence | Frequent or always bladder or bowel incontinent | Comatose, end-stage disease or hospice care. | + | |
Severely impaired decision making and short term memory problem. | |||||
Total ADL dependence in bed mobility, transfer toilet or locomotion. | |||||
cnt04 | Urinary tract infection | UTI | End-stage disease or hospice care. | ||
inf01 | Infections prevalence | Pneumonia, COPD, septicemia, Sexually transmitted disease, UTI or viral hepatitis | End-stage disease or hospice care. | + | |
nut01 | Feeding tube prevalence | Comatose, end-stage disease or hospice care. | (1) Swallowing problem and stroke | + | |
bmi0x | Low body mass index prevalence | bmi < = 19 | End-stage disease or hospice care. | + | |
pai01 | Inadequate pain management prevalence | Daily moderate or worse pain | (1) Dependent in daily decision making | + | |
pru01 | Pressure ulcer prevalence | PU | + | ||
pru02 | High risk pressure ulcer prevalence | PU | Comatose. | + | |
Low risk PU (see pru03) | |||||
pru03 | Low risk pressure ulcer prevalence | PU | Comatose. | + | |
Extensive assistance or more with toilet transfer or bed mobility. | |||||
bur0x | Burns, skin tears or cuts prevalence | Burns, skin tears or cuts | + | ||
Treatments and procedures | |||||
soc02 | Little/no activity prevalence | Little or no time involved in activities | Comatose, end-stage disease or hospice care. | ||
drg01 | Antipsychotic prevalence | Use of antipsychotic(s) | End-stage disease or hospice care. | + | |
Psychotic disorder. | |||||
drg02 | High risk antipsychotic prevalence | Use of antipsychotic(s) | End-stage disease or hospice care. | + | |
Low risk AP (see drg03) | |||||
drg03 | Low risk antipsychotic prevalence | Use of antipsychotic(s) | End-stage disease or hospice care. | + | |
Psychotic disorder. | |||||
Dependent in daily decision making. | |||||
Short term memory problem. | |||||
Behaviour symptoms score. | |||||
adp01 | Antidepressant prevalence | Use of antidepressant(s) | + | ||
vac01 | Influenza vaccination prevalence | Influenza vaccination in last 12 months | |||
cat02 | Indwelling catheter prevalence | Indwelling catheter | End-stage disease or hospice care. | (1) Frequent or always bowel incontinent | |
(2) Stage 3+ PU | |||||
res01 | Physical restraints use prevalence | Daily used trunk restraint or chair that prevents rising | |||
Incidence indicators | |||||
Physical functions | |||||
adl01 | Late-loss ADL decline | Scores as compared to previous scores 6 for bed mobility, transfer toilet, eating, toilet use: +1 on at least two of the items or +2 on one item. | Comatose, end-stage disease or hospice care. | ||
At previous assessment such a (high/low) score on items that numerator conditions cannot be met. 7 | |||||
adl02 | ADL decline following an improvement | Score on adl-lf 8 lower than previous AND score on previous adl-lf higher than at the assessment before previous. | Comatose, end-stage disease or hospice care. | ||
adl03 | ADL improvement | Score on adl-lf lower than previous | Comatose, end-stage disease or hospice care. | ||
Person or caregivers do not believe improvement possible. | |||||
mob01 | Locomotion worsening | Score on locomotion adl higher than previous | Comatose, end-stage disease or hospice care. | (1) Fell | + |
(2) Extensive assistance eating | |||||
(3) Extensive assistance toilet use | |||||
fal01 | Falls increase | Fell in last 30 days | At previous assessment not a fall in last 30 days | (1) Bedbound | |
(2) Wandering behaviour | |||||
(3) Unsteady gait and cps > =2 | |||||
Mental functions | |||||
cog01 | Cognitive decline | Score on cps higher than previous | Comatose, end-stage disease or hospice care. | (1) Frequent or always bowel incontinent | + |
(2) Fell in last 30 days | |||||
(3) Weight loss | |||||
(4) 76+ years old | |||||
com01 | Communication decline | Score on making self understood + ability to understand others higher than previous | Comatose, end-stage disease or hospice care. | (1) Extensive assistance eating | + |
(2) Short term memory | |||||
del01 | Delirium new or persistent | Score of 2 on one or more of the delirium items OR a previous score of 2 and now 1 OR now score of 1 and cps < 4 | Comatose, end-stage disease or hospice care. | + | |
beh04 | Behaviour problem decline | Sum of behaviour symptoms scores higher than previous | Comatose | (1) Not aphasia | + |
Previous score of 0 on all of the behaviour symptoms | (2) Moderate or severe decision making problem | ||||
Health problems | |||||
cnt02 | Bowel continence decline | Score on bowel incontinence higher than previous | Comatose, end-stage disease or hospice care. | (1) Short term memory | |
(2) Extensive assistance dressing | |||||
(3) Frequent or always bladder incontinent | |||||
cnt03 | Bladder continence decline | Score on bladder incontinence higher than previous | Comatose, end-stage disease or hospice care. | (1) Short term memory | + |
(2) Extensive assistance dressing | |||||
(3) Severely impaired decision making | |||||
(4) Weight loss | |||||
wgt01 | Weight loss | 5% or more weight loss in last 30 days or 10% or more in last 180 days | End-stage disease or hospice care. | (1) Long term memory | + |
Participant in weight loss program. | (2) Extensive assistance bed mobility | ||||
(3) Daily or almost daily physically aggressive | |||||
pan01 | Pain worsening | Score on pain frequency higher than previous | (1) Dependent in daily decision making | + | |
pru04 | Pressure ulcers worsening | Score on PU stage higher than previous | (1) Extensive assistance with toilet transfer | + | |
(2) Fluctuating, precarious, deteriorating condition | |||||
(3) Extensive assistance with bed mobility | |||||
(4) Extensive assistance with locomotion | |||||
Treatments and procedures | |||||
cat01 | New indwelling catheter | Score on indwelling catheter higher than previous | End-stage disease or hospice care. | (1) Frequent or always bowel incontinent | |
(2) Stage 3+ Pressure Ulcer |