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Hibbert, Peter D.; Molloy, Charlotte J.; Cameron, Ian D.; Gray, Leonard C.; Reed, Richard L.; Wiles, Louise K.; Westbrook, Johanna; Arnolda, Gaston; Bilton, Rebecca; Ash, Ruby; Georgiou, Andrew; Kitson, Alison; Hughes, Clifford F.; Gordon, Susan J.; Mitchell, Rebecca J.; Rapport, Frances; Estabrooks, Carole; Alexander, Gregory L.; Vincent, Charles; Edwards, Adrian; Carson-Stevens, Andrew; Wagner, Cordula; McCormack, Brendan; Braithwaite, Jeffrey

The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study)

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  • Media type: E-Article
  • Title: The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study)
  • Contributor: Hibbert, Peter D.; Molloy, Charlotte J.; Cameron, Ian D.; Gray, Leonard C.; Reed, Richard L.; Wiles, Louise K.; Westbrook, Johanna; Arnolda, Gaston; Bilton, Rebecca; Ash, Ruby; Georgiou, Andrew; Kitson, Alison; Hughes, Clifford F.; Gordon, Susan J.; Mitchell, Rebecca J.; Rapport, Frances; Estabrooks, Carole; Alexander, Gregory L.; Vincent, Charles; Edwards, Adrian; Carson-Stevens, Andrew; Wagner, Cordula; McCormack, Brendan; Braithwaite, Jeffrey
  • imprint: Springer Science and Business Media LLC, 2024
  • Published in: BMC Medicine
  • Language: English
  • DOI: 10.1186/s12916-023-03224-8
  • ISSN: 1741-7015
  • Keywords: General Medicine
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>This study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) recommendations.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Sixteen conditions/processes of care amendable to estimating evidence-based care at a population level were identified from prevalence data and CPGs. Candidate recommendations (<jats:italic>n</jats:italic> = 5609) were extracted from 139 CPGs which were converted to indicators. National experts in each condition rated the indicators via the RAND-UCLA Delphi process. For the 16 conditions, 236 evidence-based care indicators were ratified.</jats:p> <jats:p>A multi-stage sampling of LTC facilities and residents was undertaken. Trained aged-care nurses then undertook manual structured record reviews of care delivered between 1 March and 31 May 2021 (our record review period) to assess adherence with the indicators.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Care received by 294 residents with 27,585 care encounters in 25 LTC facilities was evaluated. Residents received care for one to thirteen separate clinical conditions/processes of care (median = 10, mean = 9.7). Adherence to evidence-based care indicators was estimated at 53.2% (95% CI: 48.6, 57.7) ranging from a high of 81.3% (95% CI: 75.6, 86.3) for Bladder and Bowel to a low of 12.2% (95% CI: 1.6, 36.8) for Depression. Six conditions (skin integrity, end-of-life care, infection, sleep, medication, and depression) had less than 50% adherence with indicators.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>This is the first study of adherence to evidence-based care for people in LTC using multiple conditions and a standardised method. Vulnerable older people are not receiving evidence-based care for many physical problems, nor care to support their mental health nor for end-of-life care. The six conditions in which adherence with indicators was less than 50% could be the focus of improvement efforts.</jats:p> </jats:sec>
  • Access State: Open Access