Implementation of the resident assessment instrument/minimum data set in the nursing home as organization: implications for quality improvement in RN clinical assessment.
The Resident Assessment Instrument/Minimum Data Set (RAI/MDS) used in nursing homes (NHs) participating in the Federal Medicare and Medicaid programs is a state-of-the-art, computerized clinical assessment instrument. RAI/MDS-derived data are essential, used for NH reimbursement, quality measurement, regulatory quality monitoring activities, and clinical care planning. Completing or coordinating the RAI/MDS, which may be conceived of as implementation, is a federally mandated responsibility of the RN involving clinical assessment, a core professional competency of any RN. How the RAI/MDS is implemented in each NH provides evidence of how each NH as an organization understands both the RAI/MDS process and its organizational level responsibility for promotion of RN competence in clinical assessment. Research literature related to RAI/MDS development, testing, and accuracy is used to identify what is known about organizational level implementation of the RAI/MDS. Evidence-based suggestions to enhance RN competence in RAI/MDS clinical assessments, given existing organizational barriers, are provided.
Dellefield
Mary Ellen
ME
VA San Diego Health Care System, San Diego, CA, USA.
D000368:Aged; D002983:Clinical Competence; D015577:Geriatric Assessment; D006284:Health Plan Implementation; D006801:Humans; D008484:Medicaid; D006278:Medicare; D009730:Nursing Assessment; D009735:Nursing Homes; D012015:Reference Standards; D017749:Total Quality Management / Q000379:methods* / Q000592:standards; D014481:United States