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Nursing Professor Helps Create Instrument
to Measure Quality in Long-Term Care Settings

RELEASED: Aug. 30, 2005

Dr. Mary Zwygart-Stauffacher
Photo by Rick Mickelson, UW-Eau Claire

EAU CLAIRE — A nursing administrator at the University of Wisconsin-Eau Claire is part of a research team that recently completed a three-year project that tested a tool to measure the quality of nursing home care in a 30-minute inspection of a facility.

"With the growing senior population, the number of people needing nursing home services is expected to triple in the next few decades," said Mary Zwygart-Stauffacher, associate dean of the College of Nursing and Health Sciences. "Nurses, other health care providers, consumers and researchers need efficient ways to measure the quality of nursing home care."

Zwygart-Stauffacher was part of a research team that consisted of nurses, geriatricians and other researchers at the University of Missouri-Columbia. Dr. Marilyn J. Rantz, professor at the Sinclair School of Nursing and Family and Community Medicine in the School of Medicine at the University of Missouri-Columbia, heads the research team.

The team identified the dimensions of quality of care in nursing homes that are important to consumers, providers and regulators. Zwygart-Stauffacher and other researchers then visited 407 facilities in Wisconsin, Missouri and Minnesota to test the "Observable Indicators of Nursing Home Care Quality Instrument." The large-scale field testing was funded by the National Institute of Nursing Research of the National Institutes of Health.

A relationship was detected between the scores of the OIQ and the citations facilities received from surveys completed by state and federal oversight inspectors, Zwygart-Stauffacher said. This suggests that the OIQ can serve as a proxy for a full, resource-intensive team of regulators that is routinely needed for the state and federal inspections, she said.

"It appears possible to conduct an abbreviated survey, allowing regulatory agencies to focus scarce resources on facilities in need of closer scrutiny," Zwygart-Stauffacher said.

Nurses, and consumer and retired regulators participated in the research, inspecting nursing facilities and scoring the instrument, Zwygart-Stauffacher said. Each item on the instrument refers to some directly observable aspect of a nursing home, she said, adding that the instrument is designed to guide researchers, health care professionals, consumers and regulators in appraising specific indicators of quality care during a brief inspection of a nursing home.

After the extensive testing, the OIQ was reduced from 47 to 30 valid, reliable and discriminating items that have a coherent structure that describes the multidimensional concept of nursing home care quality, Zwygart-Stauffacher said.

"We have an instrument that will provide nurses, surveyors, researchers and nursing home consumers with a fast, accurate and reliable way to measure the quality of nursing home care," Zwygart-Stauffacher said. "We encourage facility staff to use the OIQ in their quality improvement programs. We anticipate that consumers will find this helpful as they make decisions about long-term care services. And we hope that regulators will consider possible options using the OIQ to target scarce survey resources."

Copies of the instrument and a user's guide have been mailed to nursing homes in the three states that participated in the project. The free instrument can be ordered at a Web site for providers, consumers, regulators and researchers.

A consumer version of the OIQ and guide for selecting a nursing home for a loved one, "The New Nursing Homes: A 20-Minute Way to Find Great Long Term Care," is available from Fairview Press at (800) 544-8207 and online book stores.

A residential care version is undergoing field testing and is expected to be available in late 2006.

For more information, contact Mary Zwygart-Stauffacher, associate dean of UW-Eau Claire's College of Nursing and Health Sciences, at (715) 836-4904 or zwygarmc@uwec.edu.

-30-

JB

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