Biomedical subjects

J N DuPaquier

Publications and source records attributed to J N DuPaquier.

3 recordsLinked to original sources

PubMed1997

Efforts to establish the reliability of the Resident Assessment Instrument.

BACKGROUND: since its original implementation in the USA, the Resident Assessment Instrument (RAI) has been used in many countries in languages other than English. This paper describes the efforts that have been made to test the inter-rater reliability of the core set of items forming the minimum data set items in the USA and in non-English speaking countries (Denmark, Iceland, Italy, Japan, Sweden and Switzerland). RESULTS: a large proportion (from 70 to 96%) of the items in the RAI achieved an adequate to excellent level of reliability, with no substantial differences across countries. The RAI met the standard for good reliability (i.e. a kappa value of 0.6 or higher) in crucial areas of functional status, such as memory, activities of daily living self-performance and support, and bowel and bladder continence in most of the countries. Indicators of mood and behavioural problems achieved adequate reliability levels of 0.4 or higher.

Activities of Daily Living↗

PubMed1997

Variation in training programmes for Resident Assessment Instrument implementation.

BACKGROUND: this paper provides an overview of the Minimum Data Set/Resident Assessment Instrument (MDS/RAI) training programmes in eight countries where the system has been introduced into nursing homes. Formal education and training in the skills of assessment and care planning of nursing home personnel is reputed to be poor. In response to this problem several researchers and clinicians view MDS/RAI implementation as an opportunity to upgrade staff knowledge in care of elderly people. RESULTS: the courses in the eight countries varied in content and length according to the different goals each interRAI researcher planned when the MDS/RAI was implemented. As expected the greatest differences in training approach were between the USA and other countries. In the USA, where the MDS/RAI was mandated for use in all nursing homes, tens of thousands of professionals had to be oriented to use the system in a relatively short period of time in order to comply with the law. The training programmes therefore tended to be very short compared with those that emerged in countries where the MDS/RAI was freely chosen and implemented.

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PubMed1997

Transitions across various continuing care settings.

PURPOSE: to compare cross-nationally the sources and rates of admission and discharge in nursing homes. METHODS: data on admission were used from the Minimum Data Set of the Resident Assessment Instrument as collected in a multi-nation database at the University of Michigan. Additional data containing longitudinal episodes were used from databases in the Netherlands, Switzerland and the USA. RESULTS: the sources and rates of admission and discharge in nursing homes vary widely between countries. In Japan 47.5% of the sample was admitted from another long-term care setting, in Italy and the USA 36% and 42% respectively were admitted directly from hospital, while in Denmark and Iceland more than 60% came from home. The longitudinal data show that in the Netherlands, residents' return to home was much more likely than in Geneva or the USA (27% vs 5% vs 10%) and that in the USA a relatively large number of nursing home residents (>45%) was discharged (intermittently) to a hospital within 180 days after first admission as compared to the Netherlands (10%). CONCLUSIONS: there are large differences between countries in admission and discharge to and from nursing homes. Various policies, payment schemes, care patterns and routine referrals influence this and can be studied with cross-national data now available.

Aged↗