title: Quality of care in one Italian nursing home measured by ACOVE process indicators.
abstract: OBJECTIVE
  To 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.
  
  
  METHODS
  Two 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 <65 years were excluded. A total of 245 patients were reviewed during the study period. The ACOVE QIs set, developed for NH processes of care, was used to assess the quality of care. Multivariate analysis was performed to identify and to assess the role of patients' characteristics on quality of processes of care by several domains of care in general medical and geriatric conditions.
  
  
  RESULTS
  With 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.
  
  
  CONCLUSIONS
  Adherence 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.
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pileggi
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Manuti
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Costantino
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
authors.forename: Aida
authors.initials: A
authors.lastname: Bianco
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
authors.forename: Carmelo G A
authors.initials: CG
authors.lastname: Nobile
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Pavia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007558:Italy; D008297:Male; D009735:Nursing Homes; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D012307:Risk Factors