Longitudinal Pressure Ulcer Rates After Adoption of Culture Change in Veterans Health Administration Nursing Homes

Journal of the American Geriatrics Society
Christine W HartmannDan Berlowitz

Abstract

To examine facility-level pressure ulcer (PrU) development rates and variations in these rates after a system-wide adoption of culture change in Veterans Health Administration (VHA) nursing homes. Four-year retrospective longitudinal design. VHA facilities (N=109) representing 132 nursing homes known as community living centers (CLCs). VHA nursing home residents. PrUs were identified using fiscal year (FY) 2008-11 Minimum Data Set (MDS) data. PrU development was defined as a Stage 2 or larger PrU on an MDS assessment with no PrU on the previous assessment. A risk adjustment model was developed using 105,274 MDS observations to predict the likelihood of PrUs (c-statistic=0.72). A Bayesian hierarchical model that adjusted for differences in the precision of PrU rates from different-size facilities was used to calculate smoothed risk-adjusted (SRA) rates for each facility. The statistical significance of the trend over the 4 years was determined by examining the 95% interval estimate for the slope. Over the 4-year period, the beginning of which coincided with the VHA's system-wide adoption of culture change as a performance measure, median SRA facility PrU development rates were fairly consistent at approximately 4%. The range in ...Continue Reading

References

Mar 9, 1994·JAMA : the Journal of the American Medical Association·E L HannanM R Chassin
Mar 15, 1996·Annals of Internal Medicine·D R BerlowitzM A Moskowitz
Sep 1, 1996·Annals of Internal Medicine·J Francis, K J Pica
Mar 1, 1997·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·D R BerlowitzH Brand
Jul 24, 2004·Journal of the American Geriatrics Society·Mona BaumgartenJay Magaziner
Mar 1, 2006·Journal of the American Medical Directors Association·Jules RosenFred Rubin
Jun 29, 2011·Joint Commission Journal on Quality and Patient Safety·Lynn M SobanLisa V Rubenstein
Jul 14, 2011·JAMA : the Journal of the American Medical Association·Yue LiDana B Mukamel
Nov 22, 2011·Health Services Research·Helena Temkin-GreenerDana B Mukamel
Mar 24, 2012·Advances in Skin & Wound Care·Andrea NiederhauserDan Berlowitz
Jun 22, 2012·Health Services Research·Michael ShwartzDan Berlowitz
Jul 12, 2012·Archives of Internal Medicine·Joan M TenoVincent Mor
Jun 20, 2013·Research in Gerontological Nursing·Jennifer A PalmerChristine W Hartmann
Nov 21, 2013·Geriatric Nursing·Mary Ellen Dellefield, Jennifer L Magnabosco
Jan 21, 2014·The Gerontologist·David C GrabowskiSheryl Zimmerman
Jan 21, 2014·The Gerontologist·Victoria ShierDebra Saliba
Aug 27, 2014·Journal of the American Geriatrics Society·Susan C MillerDenise A Tyler

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Citations

May 5, 2017·Research in Nursing & Health·Eunhee Lee
May 12, 2017·Wound Repair and Regeneration : Official Publication of the Wound Healing Society [and] the European Tissue Repair Society·Barbara M Bates-JensenAnabel Patlan
Jul 27, 2018·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Jennifer L SullivanVictoria A Parker
Apr 19, 2016·Advances in Skin & Wound Care·Christine W HartmannCarol VanDeusen Lukas
May 8, 2018·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Mikaela JorgensenJohanna I Westbrook
Apr 14, 2020·Journal of the American Medical Directors Association·Aaron M OgletreeDeborah Perfetto

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