Developing a Fracture Risk Clinical Assessment Protocol for Long-Term Care: A Modified Delphi Consensus Process

2020 ◽  
Author(s):  
Caitlin McArthur ◽  
Loretta Hillier ◽  
George Ioannidis ◽  
Jonathan D. Adachi ◽  
Lora Giangregorio ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Clinical Assessment ◽  
Long Term Care ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Term Care ◽  
Assessment Protocol ◽  
Modified Delphi

scholarly journals Strategies for the implementation of an electronic fracture risk assessment tool in long term care: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuxin Bai ◽  
Caitlin McArthur ◽  
George Ioannidis ◽  
Lora Giangregorio ◽  
Sharon Straus ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Long Term Care ◽  
Assessment Tool ◽  
Implementation Strategies ◽  
High Fracture ◽  
Term Care ◽  
Assessment Protocol ◽  
Fracture Risk Assessment Tool ◽  
Group Interviews

Abstract Background Older adults in long-term care (LTC) homes experience high rates of fractures, which are detrimental to their quality of life. The purpose of this study is to identify and make recommendations on strategies to implementing an evidence-based Fracture Risk Clinical Assessment Protocol (CAP) in LTC. Methods Following the Behaviour Change Wheel framework, we conducted six focus group interviews with a total of 32 LTC stakeholders (e.g. LTC physicians) to identify barriers and facilitators, suggest implementation strategies, and discuss whether the identified strategies were affordable, practicable, effective, acceptable, safe, and if they promote equity (APEASE). The interviews were transcribed verbatim and analyzed using thematic content analysis. Results Themes of implementation strategies that met the APEASE criteria were minimizing any increase in workload, training on CAP usage, education for residents and families, and persuasion through stories. Other strategy themes identified were culture change, resident-centred care, physical restructuring, software features, modeling in training, education for staff, social rewards, material rewards, public benchmarking, and regulations. Conclusions To implement the Fracture Risk CAP in LTC, we recommend using implementation strategies centred around minimizing any increase in workload, training on CAP usage, providing education for residents and families, and persuading through stories. Through improving implementation of the fracture risk CAP, results from this work will improve identification and management of LTC residents at high fracture risk and could inform the implementation of guidelines for other conditions in LTC homes.

scholarly journals Strategies for the Implementation of an Electronic Fracture Risk Assessment Tool in Long Term Care: A Qualitative Study

2021 ◽  
Author(s):  
Yuxin Bai ◽  
Caitlin McArthur ◽  
George Ioannidis ◽  
Lora Giangregorio ◽  
Sharon Straus ◽  
...  
Keyword(s):  
Fracture Risk ◽  
Long Term Care ◽  
Assessment Tool ◽  
High Fracture ◽  
Term Care ◽  
Assessment Protocol ◽  
Fracture Risk Assessment Tool ◽  
Group Interviews ◽  
Social Rewards

Abstract Background: Older adults in long-term care (LTC) homes experience high rates of fractures, which are detrimental to their quality of life. The purpose of this study is to identify and make recommendations on knowledge translation interventions to implementing an evidence-based Fracture Risk Clinical Assessment Protocol (CAP) in LTC. Methods: Following the Behaviour Change Wheel framework, we conducted focus group interviews with 32 LTC stakeholders (e.g. LTC physicians) to identify barriers and facilitators, suggest intervention options, and discuss whether the identified interventions were feasible. The interviews were transcribed verbatim and analyzed using thematic content analysis. Results: The intervention themes that met the APEASE criteria were minimizing any increase in workload, training on CAP usage, education for residents and families, and persuasion through stories. Other intervention themes identified were culture change, resident-centred care, physical restructuring, software features, modeling in training, education for staff, social rewards, material rewards, public benchmarking, and regulations. Conclusions: To implement the Fracture Risk CAP in LTC, KT interventions centred around minimizing any increase in workload, training on CAP usage, providing education for residents and families, and persuading through stories may be used. Results from this work will improve identification and management of LTC residents at high fracture risk and could inform the implementation of guidelines for other conditions in LTC homes.

scholarly journals Fracture Risk Assessment in Long-term Care (FRAiL): Development and Validation of a Prediction Model

2017 ◽  
Vol 73 (6) ◽  
pp. 763-769 ◽  
Author(s):  
Sarah D Berry ◽  
Andrew R Zullo ◽  
Yoojin Lee ◽  
Vincent Mor ◽  
Kevin W McConeghy ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Prediction Model ◽  
Fracture Risk ◽  
Long Term Care ◽  
Fracture Risk Assessment ◽  
Term Care ◽  
Development And Validation

scholarly journals Developing an Assessment Scale for Long-term Care Reablement Literacy in Home Care Workers in Taiwan Using a Modified Delphi Method

2020 ◽  
Author(s):  
Hsiao-Wei Yu ◽  
Tzu-Ying Chiu ◽  
Pin-Yuan Chen ◽  
Tai-Hsiang Liao ◽  
Wen-Hui Chang ◽  
...  
Keyword(s):  
Home Care ◽  
Language Proficiency ◽  
Delphi Technique ◽  
Long Term Care ◽  
Term Care ◽  
Modified Delphi ◽  
Care Workers ◽  
Modified Delphi Technique ◽  
Home Care Workers

Abstract Background Reablement is a philosophy of change in long-term care (LTC). Assessing the knowledge and competence of LTC professionals who provide reablement services is vital in an LTC research. This study aimed to develop the Scale for Assessment of Long-Term Care Reablement Literacy (LTCRL) and employ this scale in assessing the performance of home care workers. Methods To develop this scale, we employed the modified Delphi technique based on the theoretical framework of health literacy and the content of service delivery in reablement. Home care workers from the north, middle, and south of Taiwan were selected through purposive sampling (N = 119). Participants answered a self-administered questionnaire, which included items related to basic demographics and questions to test LTCRL. Results Based on the experts’ consensus on the procedure of the modified Delphi technique, the Scale for Assessment of LTCRL consists of 29 questions on four aspects of knowledge acquisition, namely, the abilities to access/obtain, understand, process and appraise, and apply/use. Results revealed that higher educational levels and better Chinese language proficiency are associated with higher LTCRL outcomes among home care workers. Conclusions The Scale for Assessment of LTCRL based on a modified Delphi technique is a useful and feasible tool for evaluating the LTCRL of home care workers who provide reablement services in Taiwan.

scholarly journals RE-IMAGINING LTC: QUANTITATIVE AND QUALITATIVE RESULTS OF A NATIONAL MODIFIED DELPHI STUDY, IMPLICATIONS AND NEXT STEPS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S626-S627 ◽  
Author(s):  
Rosalie A Kane ◽  
Howard Degenholtz
Keyword(s):  
United States ◽  
Delphi Study ◽  
Long Term Care ◽  
Building Blocks ◽  
The United States ◽  
Term Care ◽  
Modified Delphi ◽  
Financial Arrangements ◽  
Consumer Advocate

Abstract In 11/2016 Robert and Rosalie Kane began a 3-round Delphi study to re-imagine long-term care (LTC), , which took as a starting premise that LTSS in the United States fails to comport to the values and preferences of consumers. The Delphi study is “modified” from more typical Delphi designs because of 1) a sample sizes over 100, 2) an unusually broad topic--optimal LTC systems if not constrained by existing programs, financial arrangements and regulations; and 3) incorporation of new sample at each round. Round 1 asked respondents to rate and add to a list of values important to LTC< but largely was an open-ended request for respondents’ ideas, Round 2 was fielded in 6/2018 with all data collection completed by 11/2018 (the delay partly due to Robert Kane’s sudden death on March 6, 2017 and also the time needed to analyze, summarize and present the complex and detailed responses to the first round). Round 3, to be fielded in 4/2019., will provide participants with the ratings of values, principles and programmatic building blocks at Round Two, and the open-ended comment of respondents in explanation of their ratings. Each Round is analyzed cross-sectionally and can be considered a separate “virtual town square.” Ellen McCreedy and Rosalie Kane, respectively, present quantitative and qualitative results from the first two rounds. Discussants will each comment briefly from their perspectives as 1) state LTC policy developer,2) LTC university-based researcher; 3) consumer advocate, followed by audience and presenter discussion of the implications of the findings.

Evaluation of the Predictive Accuracy of the interRAI Falls Clinical Assessment Protocol, Scott Fall Risk Screen, and a Supplementary Falls Risk Assessment Tool Used in Residential Long-Term Care: A Retrospective Cohort Study

2020 ◽  
Vol 39 (4) ◽  
pp. 521-532
Author(s):  
Kathleen J. Norman ◽  
John P. Hirdes
Keyword(s):  
Risk Assessment ◽  
Cohort Study ◽  
Fall Risk ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Predictive Accuracy ◽  
Term Care ◽  
Assessment Protocol ◽  
Residential Long Term Care

ABSTRACTFalls in residential long-term care (LTC) facilities continue to be a leading cause of injury for residents and cost for the health care system. Interdisciplinary clinical teams are responsible for assessing risk levels for their residents and developing appropriate care plans and interventions in response. This study compares the predictive accuracy of three separate fall risk assessment tools: the interRAI Falls Clinical Assessment Protocol (CAP), derived from the LTC Facility (LTCF) or Minimum Data Set (MDS) 2.0 assessments; the Scott Fall Risk Screen; and a modified Fall Risk Tool that was implemented as part of a provincial Fall Reduction Strategy in Nova Scotia. To conduct this retrospective cohort study, secondary data were collected from 1,553 LTC residents with interRAI assessments completed between March 1, 2015 and September 29, 2016, across Nova Scotia and New Brunswick. For each resident, data were collected regarding the three fall risk assessments, along with fall incident data for use in sensitivity, specificity, and logistic regression analyses. This study found that although all three tools had limitations with sensitivity or specificity thresholds, the interRAI Falls CAP delivered the highest accuracy with a c-statistic of 0.673, compared with the Scott Fall Risk Screen at 0.529 and the modified Fall Risk Tool at 0.609. When diseases that have been established to be a risk factor for falls were added to the model, the overall accuracy of the interRAI Falls CAP combined with those covariates increased to 0.749. These results suggest that the best practice guidelines for fall risk assessment be revisited, and that the interRAI Falls CAP could potentially be updated to include certain diseases and controls for optimal predictive ability.

scholarly journals FRACTURE RISK ASSESSMENT IN LONG-TERM CARE (FRAIL) PREDICTS NON-VERTEBRAL FRACTURES

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 58-58
Author(s):  
S Berry ◽  
A R Zullo ◽  
Y Lee ◽  
L Daiello ◽  
K McConeghy ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Fracture Risk ◽  
Vertebral Fractures ◽  
Long Term Care ◽  
Fracture Risk Assessment ◽  
Term Care
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