Decision to transfer to hospital from the residential aged care setting: a systematic review of qualitative evidence exploring residential aged care staff experiences

Abstract Background: Staff who are employed in residential aged care settings face a unique set of challenges and stressors in their workplaces which intensify their risks of occupational stress and burnout. Staff also experience low job satisfaction, increased sick time and absenteeism and high job turnover rates as a result of occupational burnout. As the population ages, there is an increased need for residential aged care (RAC) staff in Australia. It is both urgent and necessary to explore interventions that can prevent the likelihood of occupational burnout on RAC staff. A systematic review will be conducted on the effectiveness of interventions for preventing occupational burnout in RAC staff, with a view to determine the most effective type or types of intervention for such staff.Objective: To evaluate the effectiveness of interventions compared to inactive control intervention (usual care or practice) for preventing occupational burnout in RAC staff. Methods: This protocol was developed in accordance to the reporting standards of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Included studies that meet the eligibility criteria will be identified by systematic searches of electronic databases. The PRISMA flowchart will also be utilised to record the selection process. Two reviewers will extract data and assess the quality of each study independently. The Standardised Mean Differences (SMDs) with 95% confidence intervals (CIs) will be utilised in order to combine different burnout measures or scales. Extracted studies which are sufficiently similar will be included for meta-analyses. The Cochrane risk of bias (RoB 2) tool will also be utilised in order to assess the methodological quality of randomised controlled trials.Results: Systematic searches will begin at the end of 2021. Data extraction will commence in early to mid-2022. Data analyses and writing will start in late 2022.Conclusions: Intervention studies from systematic searches of databases will be identified and recommendations will be made regarding the effectiveness of interventions for RAC staff.

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Activities outside of the care setting for people with dementia: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-040753 ◽

2020 ◽

Vol 10 (10) ◽

pp. e040753

Author(s):

Nathan Martin D'Cunha ◽

Stephen Isbel ◽

Andrew J McKune ◽

Jane Kellett ◽

Nenad Naumovski

Keyword(s):

Systematic Review ◽

Care Setting ◽

Aged Care ◽

Residential Aged Care ◽

Cochrane Library ◽

Control Group ◽

Care Providers ◽

Post Intervention ◽

Horse Riding ◽

People With Dementia

ObjectivesTo summarise the evidence from interventions investigating the effects of out of care setting activities on people with dementia living in residential aged care.DesignA systematic review.MethodsA systematic search of electronic databases (PubMed, PsycINFO, Scopus, Web of Science and the Cochrane Library) was performed to identify intervention trials published from journal inception to January 2020. Controlled trials, or quasi-experimental trials, which measured pre-intervention, post-intervention or during-intervention outcomes, where the participants were required to leave the care setting to participate in an intervention, were eligible for inclusion. Quality appraisal of the studies was performed following the Cochrane Collaboration’s Risk of Bias or Newcastle-Ottawa Scale tools.ResultsOf the 4155 articles screened, 11 articles met the inclusion criteria from 9 different studies. The number of participants in the studies ranged from 6 to 70 people living with dementia and lasted for 3 weeks up to 5 months. The interventions were aquatic exercise, wheelchair cycling, art gallery discussion groups, an intergenerational mentorship programme, horse riding, walking and outdoor gardening. Overall, the studies indicated preliminary evidence of psychological (n=7), physical (n=4) and physiological (n=1) benefits, and all interventions were feasible to conduct away from the aged care facilities. However, the low number of participants in the included studies (n=177), the absence of a control group in all but three studies, and potential for selection bias, limits the generalisability of the findings.ConclusionsActivities outside of the residential aged care setting have the potential to be effective at providing a range of benefits for people living with dementia. Higher quality studies are required to encourage care providers to implement these type of activities in dementia care settings.PROSPERO registration numberCRD42020166518.

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