Setting standards for long term care of the elderly in hospital.

Subjects, methods, and results We sought the views of the patients and nursing staff in 12 long term care wards in geriatric hospitals. Only 28 of the 188 patients had a score on mental testing greater than or equal to 7/10 and were eligible for inclusion. We interviewed the two most senior trained nursing staff present when we visited each ward. On two wards only one trained nurse was present during the visit, and we therefore interviewed 22 nursing staff. Interviews were conducted with a schedule ofquestions about the regime and environment that contained 59 statements derived from questionnaires used to evaluate institutional care.' Subjects were asked to indicate their views by answering the question "Do you think it is appropriate that...?" followed by each statement. Responses were coded as "yes," "no," or "don't know." "Don't know" was classified with "no" as the emphasis of the study was to identify positive preferences. A greater proportion of nursing staff than patients were in favour of most aspects of the regime and environment, and this was significant for 19 of the 59 statements (p<005, Xy test). A majority of both the staff and the patients were in favour of 26 of the statements, which were therefore taken as standards. None of these standards was met by all the wards, but most were met by at least one ward (table).