173x Filetype PPTX File size 0.48 MB Source: clas.uiowa.edu
Presentation Outline 1. Why Minimum Data Set (MDS) 2.0 Mood Section was Changed to use the PHQ 9? 2. Homecare Depression Care Management (DCM) Protocol a. A Model for Nursing Home Social Work 3. Role of the Social Worker in DCM DARE Criteria: A Tool for Interdisciplinary Planning 2 Why were MDS 2.0 Mood Items Replaced in the MDS 3.0? Old mood item: Repeatedly shown to have poor correspondence with independent mood assessment Does not comport with accepted standard of self-report Requires time consuming systematic observations of ALL residents across all shifts. Difficult to achieve. Questionable utility for gauging response to treatment, since appropriate approach is targeting DSM-IV signs and symptoms 3 Why Mood Items Replaced (Cont’d) New cognitive item (PHQ-9) Based on DSM-IV criteria Validity well established in other settings Increasing use and recognition by clinicians Allows threshold definition AND severity definition that can track change over time Has been used in outpatient elders, hospital, rehabilitation (post stroke) and home health populations in addition to younger adult populations 4 Research and NH Validation Study Staffs rated MDS 3.0 Section Improved 87% nurses and interdisciplinary facility staffs rated the mood section as improved over 2.0 section Only 22% reported that 2.0 section was easy to complete accurately 88% felt PHQ-9 interview was better than 2.0 observation for capturing resident mood 84% felt the items could inform care plans 86% reported that items provided new insights into mood 77% felt that all residents who answered understood 5 items (6% disagreed) 78% rated ability to calculate score helpful (4% disagreed) Evidenced-Base for the Homecare Depression Care Management (DCM) Protocol Training in Assessment of Depression (TRIAD) trial found that HHA nurses can be effectively trained in depression assessment. - Martha Bruce, Journal of the American Geriatric Society, 2007 Depression care management (DCM) protocol, called the Depression CARE of PATients at Home (CAREPATH) intervention, can be used as part of routine care and can be integrated into HHA software. - Bruce, Home Healthcare Nurse July 2011 Components and utility of DCM and CAREPATH, the PHQ 9 cut points and antidepressant are described in a follow-up article. - Bruce, Home Healthcare Nurse Sept. 2011 08/27/2022 6
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