SNZ HB 8163:2005
Indicators for safe aged-care and dementia-care for consumers
Provides a basis for enhancing the effectiveness of residential aged-care and dementia-care services by specifying a core set of evidence based indicators. These indicators can be used to monitor and compare the performance of the service providers at an individual as well as national level. It is expected that the information generated via these indicators will culminate at a national level, and ultimately lead to continuous improvement of residential aged-care and dementia-care services.
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COMMITTEE REPRESENTATION
ACKNOWLEDGEMENT
CONTENTS
Copyright
REFERENCED DOCUMENTS
FOREWORD
1 INTRODUCTION
1.1 General background
1.2 Background to the development of the Handbook
1.2.1 Change of focus
1.2.2 Multi-disciplinary teams
1.2.3 Interlinking of indicators
1.2.4 Focus on safety
1.2.5 Timeliness of indicators
1.2.6 Emphasizing a culture of improvement and a no blame culture
1.2.7 First attempts
1.3 Implementation challenges
1.3.1 Cost of implementation and funding
1.3.2 Additional assessments
1.3.3 Registered nurse/registered health professional input
1.3.4 Training requirements
1.3.5 Reporting requirements
1.3.6 Use of data
1.3.7 Mandatory compliance versus voluntary best practice
1.4 Relationship with Health and Disability Sector Standards
1.5 Format and structure
1.6 Using indicators to measure quality and safety
1.6.1 What is an indicator?
1.6.2 Type of indicator
1.6.3 Why are indicators needed?
1.6.4 Indicator Interpretation
1.6.5 Method of selecting effective indicators
1.6.6 Indicator users
1.6.7 Limitations of indicators
1.6.8 Linkages to other indicator frameworks
1.6.9 Measurement and data collection
1.6.10 Collecting data
1.6.11 Impact of measuring data
1.6.12 Objective of data collection
1.6.13 Method of data collection
1.6.14 Reporting of data collected
1.6.15 Comparing data
1.6.16 Responding to results
1.6.17 Communicating results
1.7 Purpose
1.8 Scope
2 Recommended indicators for consumer aged-care and dementia-care
2.1 Indicator 1 Monitoring service provider (direct care staff) levels
2.1.1 Additional information staffing inputs and outcomes
2.1.1.2 Recommendations of the Expert Advisory Panel (EAP) for nursing specification in consumer aged-care and dementia-care
2.1.1.3 A review of the international literature on the relationship between quality of care and staffing hours in residential aged-care
2.1.1.4 Comparison of EAP recommendations and findings of the snapshot survey
2.1.1.5 Management of staffing effectiveness
2.1.1.6 Quality activities relating to staffing effectiveness
2.1.1.7 Governance
2.2(a) Indicator 2 Assessment for gait, balance and risk of falling
2.2(b) Indicator 3 Rate of falls
2.2.1 Additional information – falls
2.2.1.1 Introduction
2.2.1.2 Risk Factors
2.2.1.3 Quality
2.2.1.4 Assessment tool
2.3(a) Indicator 4 Nutritional screening
2.3(b) Indicator 5 Rates of unintentional weight loss
2.3.1 Additional information – Weight loss
2.3.1.1 Introduction
2.3.1.2 Risk factors
2.3.1.3 Quality
2.3.1.4 Example assessment tools
2.4(a) Indicator 6 Pressure ulcer risk assessment
2.4(b) Indicator 7 Rate of pressure ulcers
2.4.1 Additional information – pressure ulcers
2.4.1.1 Introduction
2.4.1.2 Risk factors
2.4.1.3 Quality
2.4.1.4 Example assessment tools
2.5 Indicator 8 Rate of urinary tract infections (UTIs)
2.5.1 Additional information – urinary tract infections (UTIs)
2.5.1.3 Quality
2.5.1.4 Example assessment tools
2.6 Indicator 9 Comprehensive pain assessment
2.6.1 Additional information – untreated pain
2.6.1.1 Introduction
2.6.1.2 Risk factors
2.6.1.3 Assessment of pain
2.6.1.4 Pain management
2.6.1.5 Quality
2.7 Indicator 10 Timely assessment for depression
2.7.1 Additional Information – Depression
2.7.1.1 Introduction
2.7.1.2 Evaluation of depression
2.7.1.3 Management
2.7.1.4 Risk factors
2.7.1.5 Quality activities relating to depression
2.7.1.6 Example assessment tools
APPENDIX A DEFINITION OF TERMS
APPENDIX B SAMPLE RECORDING SHEET
APPENDIX C AGED RESIDENTIAL CARE TOOLS (ARCAT) LISTS
APPENDIX D REFERENCES
Table 1 – Nursing specifications for consumer aged-care registered nurse staffing hours (EAP)
Table 2 – Staffing quality threshold
Table 3 – Comparison of survey findings and EAP recommendations (hours per consumer per week)
Table 4 – Recommended hours per consumer per week
Table 5 – Relationship between inputs, processes and outcomes for falls
Table 6 – Relationship between inputs, processes and outcomes for unintentional weight loss
Table 7 - Relationship between inputs, processes and outcomes for pressure ulcers
Table 8 – Relationship between inputs, processes and outcomes for UTIs
Table 9 - Relationship between inputs, processes and outcomes for pain
Table 10 – Relationship between inputs, processes and outcomes for depression
Table 11 - Symptoms, action and goals
Table 12 – Geriatric depression scale
Figure 1 - Flowchart indicating the relationship between data and process improvement
Figure 2 - Flowchart of pressure ulcer prevention strategies
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References
National Mental Health Sector Standard
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COMMITTEE REPRESENTATION
ACKNOWLEDGEMENT
CONTENTS
Copyright
REFERENCED DOCUMENTS
FOREWORD
1 INTRODUCTION
1.1 General background
1.2 Background to the development of the Handbook
1.2.1 Change of focus
1.2.2 Multi-disciplinary teams
1.2.3 Interlinking of indicators
1.2.4 Focus on safety
1.2.5 Timeliness of indicators
1.2.6 Emphasizing a culture of improvement and a no blame culture
1.2.7 First attempts
1.3 Implementation challenges
1.3.1 Cost of implementation and funding
1.3.2 Additional assessments
1.3.3 Registered nurse/registered health professional input
1.3.4 Training requirements
1.3.5 Reporting requirements
1.3.6 Use of data
1.3.7 Mandatory compliance versus voluntary best practice
1.4 Relationship with Health and Disability Sector Standards
1.5 Format and structure
1.6 Using indicators to measure quality and safety
1.6.1 What is an indicator?
1.6.2 Type of indicator
1.6.3 Why are indicators needed?
1.6.4 Indicator Interpretation
1.6.5 Method of selecting effective indicators
1.6.6 Indicator users
1.6.7 Limitations of indicators
1.6.8 Linkages to other indicator frameworks
1.6.9 Measurement and data collection
1.6.10 Collecting data
1.6.11 Impact of measuring data
1.6.12 Objective of data collection
1.6.13 Method of data collection
1.6.14 Reporting of data collected
1.6.15 Comparing data
1.6.16 Responding to results
1.6.17 Communicating results
1.7 Purpose
1.8 Scope
2 Recommended indicators for consumer aged-care and dementia-care
2.1 Indicator 1 Monitoring service provider (direct care staff) levels
2.1.1 Additional information staffing inputs and outcomes
2.1.1.2 Recommendations of the Expert Advisory Panel (EAP) for nursing specification in consumer aged-care and dementia-care
2.1.1.3 A review of the international literature on the relationship between quality of care and staffing hours in residential aged-care
2.1.1.4 Comparison of EAP recommendations and findings of the snapshot survey
2.1.1.5 Management of staffing effectiveness
2.1.1.6 Quality activities relating to staffing effectiveness
2.1.1.7 Governance
2.2(a) Indicator 2 Assessment for gait, balance and risk of falling
2.2(b) Indicator 3 Rate of falls
2.2.1 Additional information – falls
2.2.1.1 Introduction
2.2.1.2 Risk Factors
2.2.1.3 Quality
2.2.1.4 Assessment tool
2.3(a) Indicator 4 Nutritional screening
2.3(b) Indicator 5 Rates of unintentional weight loss
2.3.1 Additional information – Weight loss
2.3.1.1 Introduction
2.3.1.2 Risk factors
2.3.1.3 Quality
2.3.1.4 Example assessment tools
2.4(a) Indicator 6 Pressure ulcer risk assessment
2.4(b) Indicator 7 Rate of pressure ulcers
2.4.1 Additional information – pressure ulcers
2.4.1.1 Introduction
2.4.1.2 Risk factors
2.4.1.3 Quality
2.4.1.4 Example assessment tools
2.5 Indicator 8 Rate of urinary tract infections (UTIs)
2.5.1 Additional information – urinary tract infections (UTIs)
2.5.1.3 Quality
2.5.1.4 Example assessment tools
2.6 Indicator 9 Comprehensive pain assessment
2.6.1 Additional information – untreated pain
2.6.1.1 Introduction
2.6.1.2 Risk factors
2.6.1.3 Assessment of pain
2.6.1.4 Pain management
2.6.1.5 Quality
2.7 Indicator 10 Timely assessment for depression
2.7.1 Additional Information – Depression
2.7.1.1 Introduction
2.7.1.2 Evaluation of depression
2.7.1.3 Management
2.7.1.4 Risk factors
2.7.1.5 Quality activities relating to depression
2.7.1.6 Example assessment tools
APPENDIX A DEFINITION OF TERMS
APPENDIX B SAMPLE RECORDING SHEET
APPENDIX C AGED RESIDENTIAL CARE TOOLS (ARCAT) LISTS
APPENDIX D REFERENCES
Table 1 – Nursing specifications for consumer aged-care registered nurse staffing hours (EAP)
Table 2 – Staffing quality threshold
Table 3 – Comparison of survey findings and EAP recommendations (hours per consumer per week)
Table 4 – Recommended hours per consumer per week
Table 5 – Relationship between inputs, processes and outcomes for falls
Table 6 – Relationship between inputs, processes and outcomes for unintentional weight loss
Table 7 - Relationship between inputs, processes and outcomes for pressure ulcers
Table 8 – Relationship between inputs, processes and outcomes for UTIs
Table 9 - Relationship between inputs, processes and outcomes for pain
Table 10 – Relationship between inputs, processes and outcomes for depression
Table 11 - Symptoms, action and goals
Table 12 – Geriatric depression scale
Figure 1 - Flowchart indicating the relationship between data and process improvement
Figure 2 - Flowchart of pressure ulcer prevention strategies
SNZ HB 8163:2005
Online Library subscription information
Online library subscriptions provide a cost-effective solution for organisations of any size to access the latest standards, offering 24/7 access to a personalised catalogue. The service ensures subscribers have have the most up-to-date version of selected standards, incluing automatic updates for any amendments or versions. Pricing is dependent on the chosen standards and the number of concurrent users, with discounts applied from the standards PDF price. For customised subscriptions or further inquiries, contact the Online Library team.