Cargando…

Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs)

BACKGROUND: The interRAI Palliative Care (interRAI PC) assessment instrument provides a standardized, comprehensive means to identify person-specific need and supports clinicians to address important factors such as aspects of function, health, and social support. The interRAI Clinical Assessment Pr...

Descripción completa

Detalles Bibliográficos
Autores principales: Freeman, Shannon, Hirdes, John P, Stolee, Paul, Garcia, John, Smith, Trevor Frise, Steel, Knight, Morris, John N
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279598/
https://www.ncbi.nlm.nih.gov/pubmed/25550682
http://dx.doi.org/10.1186/1472-684X-13-58
_version_ 1782350724867293184
author Freeman, Shannon
Hirdes, John P
Stolee, Paul
Garcia, John
Smith, Trevor Frise
Steel, Knight
Morris, John N
author_facet Freeman, Shannon
Hirdes, John P
Stolee, Paul
Garcia, John
Smith, Trevor Frise
Steel, Knight
Morris, John N
author_sort Freeman, Shannon
collection PubMed
description BACKGROUND: The interRAI Palliative Care (interRAI PC) assessment instrument provides a standardized, comprehensive means to identify person-specific need and supports clinicians to address important factors such as aspects of function, health, and social support. The interRAI Clinical Assessment Protocols (CAPs) inform clinicians of priority issues requiring further investigation where specific intervention may be warranted and equip clinicians with evidence to better inform development of a person-specific plan of care. This is the first study to describe the interRAI PC CAP development process and provide an overview of distributional properties of the eight interRAI PC CAPs among community dwelling adults receiving palliative home care services. METHODS: Secondary data analysis used interRAI PC assessments (N = 6,769) collected as part of regular clinical practice at baseline (N = 6,769) and follow-up (N = 1,000). Clients across six regional jurisdictions in Ontario, Canada, assessed to receive palliative homecare services between 2006 and 2011 were included (mean age 70.0 years; ±13.4 years). Descriptive analyses focused on the eight interRAI PC CAPs: Fatigue, Sleep Disturbance, Nutrition, Pressure Ulcers, Pain, Dyspnea, Mood Disturbance and Delirium. RESULTS: The majority of clients triggered at least one CAP while two thirds triggered two or more. Triggering rates ranged from 74% for the Fatigue CAP to less than 15% for the Delirium and Pressure Ulcers CAPs. The hierarchical CAP triggering structure suggested Fatigue and Dyspnea CAPs were persistent issues prevalent among the majority of clients while Delirium and Pressure Ulcers CAPs rarely trigger in isolation and most often trigger later in the illness trajectory. CONCLUSION: When any of the eight interRAI PC CAPs are triggered, clinicians should take notice. CAPs triggered at high rates such as fatigue, dyspnea, and pain warrant increased attention for the majority of clients. Consideration of triggered CAPs provide evidence to inform a collaborative decision making process on whether or not issues raised by the CAPs should be addressed in the plan of care. Integrating evidence from the interRAI PC CAPs into the clinical decision making process support care planning to address client strengths, preferences and needs with greater acuity.
format Online
Article
Text
id pubmed-4279598
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-42795982014-12-31 Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs) Freeman, Shannon Hirdes, John P Stolee, Paul Garcia, John Smith, Trevor Frise Steel, Knight Morris, John N BMC Palliat Care Research Article BACKGROUND: The interRAI Palliative Care (interRAI PC) assessment instrument provides a standardized, comprehensive means to identify person-specific need and supports clinicians to address important factors such as aspects of function, health, and social support. The interRAI Clinical Assessment Protocols (CAPs) inform clinicians of priority issues requiring further investigation where specific intervention may be warranted and equip clinicians with evidence to better inform development of a person-specific plan of care. This is the first study to describe the interRAI PC CAP development process and provide an overview of distributional properties of the eight interRAI PC CAPs among community dwelling adults receiving palliative home care services. METHODS: Secondary data analysis used interRAI PC assessments (N = 6,769) collected as part of regular clinical practice at baseline (N = 6,769) and follow-up (N = 1,000). Clients across six regional jurisdictions in Ontario, Canada, assessed to receive palliative homecare services between 2006 and 2011 were included (mean age 70.0 years; ±13.4 years). Descriptive analyses focused on the eight interRAI PC CAPs: Fatigue, Sleep Disturbance, Nutrition, Pressure Ulcers, Pain, Dyspnea, Mood Disturbance and Delirium. RESULTS: The majority of clients triggered at least one CAP while two thirds triggered two or more. Triggering rates ranged from 74% for the Fatigue CAP to less than 15% for the Delirium and Pressure Ulcers CAPs. The hierarchical CAP triggering structure suggested Fatigue and Dyspnea CAPs were persistent issues prevalent among the majority of clients while Delirium and Pressure Ulcers CAPs rarely trigger in isolation and most often trigger later in the illness trajectory. CONCLUSION: When any of the eight interRAI PC CAPs are triggered, clinicians should take notice. CAPs triggered at high rates such as fatigue, dyspnea, and pain warrant increased attention for the majority of clients. Consideration of triggered CAPs provide evidence to inform a collaborative decision making process on whether or not issues raised by the CAPs should be addressed in the plan of care. Integrating evidence from the interRAI PC CAPs into the clinical decision making process support care planning to address client strengths, preferences and needs with greater acuity. BioMed Central 2014-12-15 /pmc/articles/PMC4279598/ /pubmed/25550682 http://dx.doi.org/10.1186/1472-684X-13-58 Text en © Freeman et al.; licensee BioMed Central. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Freeman, Shannon
Hirdes, John P
Stolee, Paul
Garcia, John
Smith, Trevor Frise
Steel, Knight
Morris, John N
Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs)
title Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs)
title_full Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs)
title_fullStr Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs)
title_full_unstemmed Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs)
title_short Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs)
title_sort care planning needs of palliative home care clients: development of the interrai palliative care assessment clinical assessment protocols (caps)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279598/
https://www.ncbi.nlm.nih.gov/pubmed/25550682
http://dx.doi.org/10.1186/1472-684X-13-58
work_keys_str_mv AT freemanshannon careplanningneedsofpalliativehomecareclientsdevelopmentoftheinterraipalliativecareassessmentclinicalassessmentprotocolscaps
AT hirdesjohnp careplanningneedsofpalliativehomecareclientsdevelopmentoftheinterraipalliativecareassessmentclinicalassessmentprotocolscaps
AT stoleepaul careplanningneedsofpalliativehomecareclientsdevelopmentoftheinterraipalliativecareassessmentclinicalassessmentprotocolscaps
AT garciajohn careplanningneedsofpalliativehomecareclientsdevelopmentoftheinterraipalliativecareassessmentclinicalassessmentprotocolscaps
AT smithtrevorfrise careplanningneedsofpalliativehomecareclientsdevelopmentoftheinterraipalliativecareassessmentclinicalassessmentprotocolscaps
AT steelknight careplanningneedsofpalliativehomecareclientsdevelopmentoftheinterraipalliativecareassessmentclinicalassessmentprotocolscaps
AT morrisjohnn careplanningneedsofpalliativehomecareclientsdevelopmentoftheinterraipalliativecareassessmentclinicalassessmentprotocolscaps