The Power of Collaborative Research
Nursing Home Star Ratings and End-of-Life Care Quality: Lessons Learned from the Veterans Health Administration.
Over 25% of deaths among older adults occur in nursing homes. Therefore, it is crucial that assessments of nursing home quality, such as the commonly used 5-star rating systems, adequately reflect the quality of end-of-life care. To investigate this relationship, we conducted a national, retrospective observational study to explore the relationship between Veterans Affairs nursing home star ratings and the quality of end-of-life care. We found no relationship between star ratings and bereaved families' experience at the end of life.
Palliative Care in Nursing Homes: A Qualitative Study on Referral Criteria and Implications for Research and Practice.
Palliative care is vital for nursing home residents to improve their quality of life and care, yet it is underutilized in nursing homes. Palliative care underutilization in nursing homes is associated with multifaceted barriers such as vague and ill-defined referral criteria. To improve palliative care utilization in nursing homes, we used a qualitative descriptive approach to examine existing referral practices, explored recommendations for ideal criteria, and integrated both to create a framework for palliative care referral in nursing homes.
A Nurse Practitioner Driven Palliative and Supportive Care Service in Nursing Homes: Evaluation of a Quality Improvement Project.
Post-acute and long-term care residents often face untreated pain, misalignment between care goals and treatments, and missed psychosocial support opportunities. Developing internal palliative care programs in these settings aims to address these unmet needs by enhancing skills within the facility. This quality improvement project describes the initial steps and experiences of nurse practitioners involved in implementing a palliative and supportive care service to enhance care quality in a national post-acute and long-term care organization.
Staff perspectives on dementia care in nursing homes: A pre-implementation, qualitative study guided by the PRISM.
Person-centered, nonpharmacological interventions for people living with dementia have been shown to enhance affect, engagement, and communication while reducing negative behaviors. Despite their effectiveness, many of these interventions struggle to reach routine clinical settings due to implementation barriers. This pre-implementation study uses the Practical, Robust Implementation, and Sustainability Model to evaluate factors influencing the implementation of Dementia Collaborative Coaching in nursing homes, aiming to improve access to person-centered communication interventions for people living with dementia.
Selecting Outcomes for Pragmatic Clinical Trials in Dementia Care: the IMPACT Collaboratory iLibrary
Pragmatic outcomes are relevant in caring for people living with Alzheimer's Disease and related dementias (ADRD), and their care partners. Additionally, pragmatic outcomes must be readily measured and interpreted by clinicians within clinical workflow. Existing administrative data sources are highly pragmatic; however, they fail to address many domains and settings in ADRD care. To facilitate ADRD pragmatic trials, we created the IMPACT Patient and Caregiver Relevant Outcomes (PCRO) iLibrary and this study aims to detail its development and structure and assess the pragmatic characteristics of the included measures.