Development of an assessment tool for preventive home visits

PURPOSE: To develop a new version of the Minimum Data Set-Home Care (MDS-HC) for preventive home visits. METHODS: Public health nurses (PHNs) visited community dwelling elderly who were independent in ADL but dependent in IADL, every three months using the MDS-HC. Assessment forms and visiting records documented by the PHNs at the third visit (n = 217) and the assessment forms available from the third to the fifth visit (n = 163) were analyzed. Assessment items appropriate for preventive home visits were selected based on frequency of problem identified, changes observed, and areas requiring follow-up identified by the PHNs. These items were evaluated for their sensitivity and specificity in identifying the areas requiring follow-up. RESULTS: 53 assessment items were selected based on the frequency of the problems identified and the changes observed. An additional 36 assessment items were needed to identify the 24 areas requiring follow-up. In total, 89 of the 247 items in the original were identified as being appropriate for the preventive version of the MDS-HC. The sensitivity of the new version to detect the 24 problem areas were the same or higher than with the original. CONCLUSION: The preventive version of the MDS-HC had about one third of the items in the original and appropriately detected the areas that needed follow up. The use of this tool should lead to a more systematic approach to preventive health visits.