Paper
Saturday, July 24, 2004
Using Existing Data as an Evidence Source for Practice: Possibilities and Problems
Gail Cobe, RN, MSN, Carol Maher, RN, RAC-C, and Anne M. Hughes, RN, MN, FAAN. Laguna Honda Hospital and Rehabilitation Center/San Francisco Department of Public Health, San Francisco, CA, USA
Existing data are sources of evidence often suggested for nurses to use to improve their practice. Data reports may include infection control surveillance, unusual occurrences (or incident reports), drug utilization, product evaluation and mandatory clinical data collected in specific clinical areas. Since 1987 all skilled nursing facilities (SNFs) in the United States, have been required to use a standardized framework for assessing and planning care for each resident whose payment is Medicare and Medicaid. Known as the Resident Assessment Instrument (RAI), this framework contains a comprehensive screening tool, the Minimum Data Set (MDS) which collects patient specific information such as level of cognitive skills, functional status, continence, mood and behavior, nutrition, medications, rehabilitation potential, pain, and skin condition. Although constructed to be interdisciplinary, most of data collection and the process is driven by nurses. Since first introduced the data has become the foundation not only for the identification of potential problems for specific SNF residents, but has become the foundation for reimbursement, for licensing and certification surveys, quality improvement, and for benchmarking with other facilities. While important to the financial well being of the institution, its standing in the community, and to document outcomes of nursing care, there are myriad problems in the instrument and its use.
This presentation focuses on the problems of the MDS as a source of data for nursing practice and on its promise.
Back to Transforming Nursing Care Delivery in Long-Term Care (LTC): Integrating Evidence With Experience
Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004