Resident Assessment Instrument
In sick , pediatric and elderly care , RAI or in its long form “Resident Assessment Instrument” means an assessment instrument for the respective needs of nursing care. There are a number of similar procedures under this name.
Transferred to the nursing process , these instruments initially cover the assessment phase (patient admission and assignment to therapy and nursing procedures) and lead to diagnostics, priority setting and outcome evaluation (success determination).
The RAI was developed in the USA in the 1980s and is now used in many countries around the world. In the area of inpatient care for the elderly (care for the elderly), it can be seen as the international standard.
What is special about the RAI is that - in contrast to many other assessment instruments - it does not measure the amount of care required, but rather the need for care. This consequently enables the creation of a care plan that is actually tailored to individual care needs.
Several universities - also in German-speaking countries - offer courses with content from the field of health sociology and health economics . These have the goal of acquiring the qualification RAI coordinator or RAI Coordinator .
The RAI consists of the following modules:
The MDS (= “Minimum Data Set”) consists of approx. 300 items that are filled out by the responsible MDS coordinator (a member of the care team) in cooperation with the patient, the team, relatives and members of other professional groups.
The data is collected quarterly or every six months, as well as after a significant change in status.
This comparatively very detailed assessment provides, as a rough screening, an overview of the most relevant patient data.
The risk identification board
With this instrument (which can also be carried out conveniently as a computerized calculation), the RAI uses an alarm system to determine the most typical problem areas in the care setting.
The clarification aids
There is a so-called RAP (Resident Assessment Protocol; different designations depending on the setting, e.g. CAP in RAI-HC) for each problem area. The appropriate RAPs are carried out for each identified problem area. They provide information on the interactions between the problem areas, the focus to be set and any additional data that may need to be clarified in this problem area. Once the RAPs have been carried out, the basis for the individual care plan is in place.
Further areas of application
The MDS data (optional) not only serve as the basis for the care plan. So-called. "Add-ons" for the RAI, which are based on special evaluations of this data, enable z. B. a very differentiated billing with the cost bearers (RUG system = Resource Utilization Groups or maintenance effort groups) or personnel assessment, or use specially developed quality indicators to provide the database for in-house quality assurance or benchmarking. In addition, valid assessment scales for specific risks are based on the MDS. a. the Cognitive Performance Scale, the MDS-Cognition Scale, the CHESS-Scale, the Personal Severity Scale or the ADL-Index.
- Similar procedures are PLAISIR® (Planification Informatisée des Soins Infirmiers Requis; common in Canada and Switzerland), Pflegemonitor® (focus there on the analysis of patient and employee satisfaction )
- Diagnosis Related Groups - DRG
- Risk management
- John N. Morris, Catherine Hawes, et al. a., Translation into German by Vjenka Garms-Homolova, KDA (Ed.): Resident Assessment Instrument (RAI). System for client assessment and documentation. Training manual and clarification aids . KDA, Cologne 1996, Forum No. 28.
- Garms-Hormolova, Gilgen (Ed.): RAI 2.0 - Resident Assessment Instrument . Huber, 2000, ISBN 3-456-83260-5 .