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. Author manuscript; available in PMC: 2020 Sep 1.
Published in final edited form as: J Pain Symptom Manage. 2019 Jun 10;58(3):408–416.e1. doi: 10.1016/j.jpainsymman.2019.06.001

Table 2.

Prevalence of Integration of Palliative Care and Infection Management Policies among US NHs (unweighted n=859, weighted n=14,828).

Weighted % Intensity Index
Cronbach’s α Weighted μ SE
1. Patient/Caregiver Involvement in Care Planning 1 0.70 73.17 1.57
Consider residents’ goals of care in managing suspected infections near the end-of-life. 70.81
Include residents and resident proxies in treatment decisions for suspected infections near the end-of-life. 76.01
2. Formalized Advance Care Planning2 0.72 34.11 1.05
Ms. Davis would already have a “Do Not Resuscitate” order 57.35
Ms. Davis would already have a “Do Not Hospitalize” order 23.98
Ms. Davis would already have a “Do Not Administer Antibiotics” order 7.14
Ms. Davis would already have a orders reflecting “Palliative/Comfort Measures” only 26.85
A proxy for Ms. Davis would be asked how to manage the suspected infection 55.91
3. Routine Practices of Integration2 0.63 31.37 1.48
A straight catheter would be used to collect a urine sample* 30.77
Ms. Davis would be treated with antibiotics* 32.39

Note:

*

These questions were reversed coded so that a positive response was a higher value.

1

Policies were considered present if answered as “Almost Always” on Likert scale.

2

Both the Formalized Advance Care Planning and Routine Practices of Integration items came from a vignette stating, “Ms. Davis has been in your facility for 4 months. On admission, she was ambulatory and needed total assistance with feeding. She was admitted with advanced heart disease, osteoporosis, a right hip fracture, and Alzheimer’s. She takes oxycodone 10 mg every 6 hours for pain. In the past month, you notice she is eating less, has lost 10 pounds, and coughs when drinking. Ms. Davis no longer recognizes her family.” The Formalized Advance Care Planning items also stated “Over the past 24 hours, Ms. Davis developed a fever, cough, and shortness of breath and the clinical exam suggested an aspiration pneumonia. In your facility, how likely is it that…”. The Routine Practices of Integration also stated, “Over the past 24 hours, Ms. Davis appears more confused and her family mentions to the nurse that her urine looks dark and asks if she has a urinary tract infection. She has not developed a fever. In your facility, how likely is it that…”. All policies were considered present if answered as “Very Likely” on Likert scale.