Quality of Care in One Italian Nursing Home Measured by ACOVE Process Indicators

ObjectivesTo adapt the Assessing Care of Vulnerable Elders Quality Indicators (ACOVE QIs) for use in Italy, to assess the adherence to these indicators as reported in the medical records of residents in a nursing home (NH), to compare this adherence for general medical and geriatric conditions, and eventually, to identify the relationships between patients' characteristics and reported processes of care.MethodsTwo physicians collected the data by reviewing medical records of all NH residents in the previous 5 years, for a period of one year. Patients aged ResultsWith the exception of diabetes management, quality of processes of care for general medical conditions approached adequate adherence. Care falls substantially short of acceptable levels for geriatric conditions (pressure ulcers, falls, dementia). On the contrary, the recommended interventions for urinary incontinence were commonly performed. Adherence to indicators varied for the different domains of care and was proven worse for the screening and prevention indicators both for geriatric and general medical conditions. Statistical analysis showed disparities in provision of appropriate processes of care associated with gender, age, co-morbidities, level of function and mobility, length of stay and modality of discharge by NHs.ConclusionsAdherence to recommended processes of care delivered in NH is inadequate. Substantial work lies ahead for the improvement of care. Efforts should focus particularly on management of geriatric conditions and on preventive healthcare.