[Does the resident care assessment instrument improve long-term home care? - results of a nation-wide study in Germany]

Abstract

Background: Effective and efficient instruments for care planning and controlling are required to optimise the nursing process and improve outcome quality despite of various lacks of quality and precarious circumstances.

Methods: A cluster randomised controlled trial was conducted to assess whether the implementation of the Resident Assessment Instrument (RAI) into home care service providers can help to improve or stabilise functional abilities (ADL, IADL) and cognitive skills (MMST), improve quality of life (EQ-5D), reduce institutionalisation and thereby increase outcome quality.

Results: A comparison of mean differences between the treatment and control group showed no significant effects. Although the multilevel regression results show that clients in the treatment group fared better in terms of ADL and IADL (smaller decline) and were less likely to move to nursing homes and be hospitalised, none of these effects are significant.

Conclusions: The lack of significance might be due to the fact that RAI was not fully implemented and even the partial implementation lasted much longer than expected. Moreover, the number of clients included in the study was smaller than originally planned.