Validation of the MEDSAIL Tool to Screen for Capacity for Safe and Independent Living Among Nursing Home Residents.
Whitney L Mills, Mark E Kunik, P Adam Kelly and 5 others
PMID 32636169WHAT IT FOUND
In 24 nursing home residents, MEDSAIL scores were lower for residents judged to have no or partial capacity than for those judged to have full capacity.
They also matched psychiatrist determinations closely. This is early validation, not a tested tool for routine use.
Key findings
01Mean MEDSAIL scores were about 75% lower for residents judged to have no or partial capacity than for those judged to have full capacity, and the difference was statistically significant (P < .01).
02MEDSAIL scores correlated strongly with geriatric psychiatrists' capacity determinations, with reported correlations of 0.88 and 0.83.
03Five scenarios had internal consistency alpha values from 0.68 to 0.83, but scenario 5 had alpha 0.10.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 24 residents were analysed, so the result is early and not enough to guide routine use. All participants were male, and residents were excluded for severe dementia, inability to hear with devices, or inability to communicate, so the sample does not represent all nursing home residents. The site mainly provided short-stay care, which made recruitment and interviews difficult, and consent from legally authorized representatives was slow, which may have reduced participation by residents with lower capacity. One extreme outlier was excluded, and few residents had no capacity, so the no capacity and partial capacity groups were combined. MEDSAIL was not administered by nursing home staff or therapists in this study, and no clinically meaningful cut scores were established.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read this as proof that MEDSAIL is ready for routine use by nursing home staff. It was tested in 24 all-male residents, not by staff, and no clinically meaningful cut scores were found.