scholarly journals Barriers and facilitators in the integration of oral health into primary care: a scoping review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016078 ◽  
Author(s):  
Hermina Harnagea ◽  
Yves Couturier ◽  
Richa Shrivastava ◽  
Felix Girard ◽  
Lise Lamothe ◽  
...  
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Scoping Review ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Barriers And Facilitators ◽  
Dental Services ◽  
Collaborative Practices ◽  
Implementation Challenges ◽  
Healthcare Needs

ObjectiveThis scoping study has been conducted to map the literature and provide a descriptive synthesis on the barriers and facilitators of the integration of oral health into primary care.MethodsGrounded in the Rainbow conceptual model and using the Levacet alsix-stage framework, we performed a systematic search of electronic databases, organisational websites and grey literature from 1978 to April 2016. All publications with a focus on the integration of oral health into primary care were included except commentaries and editorials. Thematic analyses were performed to synthesise the results.ResultsFrom a total of 1619 citations, 58 publications were included in the review. Barrier-related themes included: lack of political leadership and healthcare policies; implementation challenges; discipline-oriented education; lack of continuity of care and services and patients’ oral healthcare needs. The facilitators of integration were supportive policies and resources allocation, interdisciplinary education, collaborative practices between dental and other healthcare professionals, presence of local strategic leaders and geographical proximity.Discussion and public health implicationsThis work has advanced the knowledge on the barriers and facilitators at each integration domain and level, which may be helpful if the healthcare organisations decide to integrate oral health and dental services into primary care. The scoping review findings could be useful for both dental and medical workforce and allied primary healthcare providers. They could also guide the development of healthcare policies that support collaborative practices and patient-centred care in the field of primary care.

scholarly journals A scoping review of registry captured indicators for evaluating quality of critical care in ICU

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Issrah Jawad ◽  
Sumayyah Rashan ◽  
Chathurani Sigera ◽  
Jorge Salluh ◽  
Arjen M. Dondorp ◽  
...  
Keyword(s):  
Critical Care ◽  
Scoping Review ◽  
Health Care Quality ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Patient Reported

Abstract Background Excess morbidity and mortality following critical illness is increasingly attributed to potentially avoidable complications occurring as a result of complex ICU management (Berenholtz et al., J Crit Care 17:1-2, 2002; De Vos et al., J Crit Care 22:267-74, 2007; Zimmerman J Crit Care 1:12-5, 2002). Routine measurement of quality indicators (QIs) through an Electronic Health Record (EHR) or registries are increasingly used to benchmark care and evaluate improvement interventions. However, existing indicators of quality for intensive care are derived almost exclusively from relatively narrow subsets of ICU patients from high-income healthcare systems. The aim of this scoping review is to systematically review the literature on QIs for evaluating critical care, identify QIs, map their definitions, evidence base, and describe the variances in measurement, and both the reported advantages and challenges of implementation. Method We searched MEDLINE, EMBASE, CINAHL, and the Cochrane libraries from the earliest available date through to January 2019. To increase the sensitivity of the search, grey literature and reference lists were reviewed. Minimum inclusion criteria were a description of one or more QIs designed to evaluate care for patients in ICU captured through a registry platform or EHR adapted for quality of care surveillance. Results The search identified 4780 citations. Review of abstracts led to retrieval of 276 full-text articles, of which 123 articles were accepted. Fifty-one unique QIs in ICU were classified using the three components of health care quality proposed by the High Quality Health Systems (HQSS) framework. Adverse events including hospital acquired infections (13.7%), hospital processes (54.9%), and outcomes (31.4%) were the most common QIs identified. Patient reported outcome QIs accounted for less than 6%. Barriers to the implementation of QIs were described in 35.7% of articles and divided into operational barriers (51%) and acceptability barriers (49%). Conclusions Despite the complexity and risk associated with ICU care, there are only a small number of operational indicators used. Future selection of QIs would benefit from a stakeholder-driven approach, whereby the values of patients and communities and the priorities for actionable improvement as perceived by healthcare providers are prioritized and include greater focus on measuring discriminable processes of care.

scholarly journals Patient-centred care for addiction treatment: a scoping review protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024588 ◽  
Author(s):  
Kirsten Marchand ◽  
Scott Beaumont ◽  
Jordan Westfall ◽  
Scott MacDonald ◽  
Scott Harrison ◽  
...  
Keyword(s):  
Substance Use ◽  
Scoping Review ◽  
Addiction Treatment ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Open Science ◽  
Patient Centred Care ◽  
Healthcare Settings ◽  
Problematic Substance Use ◽  
Problematic Substance

IntroductionSubstance use disorders are chronic conditions that require a multidimensional treatment approach. Despite ongoing efforts to diversify such treatments, evidence continues to illuminate modest rates of treatment engagement and perceived barriers to treatment. Patient-centred care (PCC) is one approach that may strengthen the responsiveness of treatments for people with problematic substance use. The aim of this scoping review is to explore how the principles of PCC have been implemented and operationalised in healthcare settings for people with problematic substance use.Methods and analysisThis scoping review follows the iterative stages of the Arksey and O’Malley framework. Both empirical (from Medline, Embase, PsycINFO, CINAHL and ISI Web of Science) and grey literature references will be considered if they focused on populations with problematic substance use and described or measured PCC or one of its principles in a health-oriented context. Two reviewers will independently screen references in two successive stages of title/abstract screening and then full-text screening for references meeting title/abstract criteria. A descriptive overview, tabular and/or graphical summaries, and a directed content analysis will be carried out on extracted data. This scoping review has been registered with Open Science Framework (https://osf.io/5swvd/).Ethics and disseminationThis review will systematically examine the extent and nature of existing evidence of PCC in addiction research and clinical practice. Such evidence will contribute to the operationalisation of PCC for people with problematic substance use. A multidisciplinary team has been gathered to represent the needs of people with problematic substance use, healthcare providers and decision-makers. The team’s knowledge users will be engaged throughout this review and will participate in dissemination activities (eg, workshops, presentations, publications, reports).

scholarly journals Barriers and facilitators to nutritional risk screening of older adults in primary care

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Christine Mills
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Grey Literature ◽  
Community Dwelling ◽  
Barriers And Facilitators ◽  
Nutritional Risk ◽  
Term Care ◽  
Risk Screening ◽  
Google Search ◽  
Nutritional Risk Screening

AbstractIntroduction:Over one-third of these community-dwelling older adults in Canada are at increased nutritional risk. Worldwide, two-thirds of older adults are at increased nutritional risk, although this figure includes those who are hospitalized or in long term care. Nutritional risk can lead to malnutrition; this occurs when an individual's food intake has an imbalance of energy, protein, or other nutrients. Nutritional risk and malnutrition are associated with poor quality of life, increased hospitalization, and premature mortality. Since malnutrition starts in the community, primary care is the ideal location for nutritional risk screening. If nutritional risk is identified early, before it progresses to malnutrition, it can be more easily treated. It is therefore important to understand barriers and facilitators to nutritional risk screening in primary care.Materials and Methods:The peer-reviewed and grey literature were searched. The databases CINAHL, Embase, Medline, and Google Scholar were used to identify articles related to barriers and facilitators to nutritional risk screening of older adults in primary care. A Google search identified publications from the grey literature related to nutritional risk screening of older adults. Key informants consisting of health care professionals working in primary care were asked to identify additional barriers. The Theoretical Domains Framework (TDF) was used to classify the barriers and facilitators.Results:Nine barriers and nine facilitators relating to nutritional risk screening of older adults in primary care were identified. These barriers and facilitators were located within the following domains of the TDF: knowledge; skills; social/professional role and identity; beliefs about capabilities; beliefs about consequences; motivation and goals; memory, attention and decision processes; environmental context and resources; social influences; emotions; behavioural regulation; and nature of the behaviours.Discussion:The TDF can be used to examine the barriers and facilitators to nutritional risk screening of older adults in primary care. Identification and classification of these barriers and facilitators can aid in the development and implementation of interventions designed to improve rates of nutritional risk screening in primary care. Identifying older adults at nutritional risk can help to prevent malnutrition, by intervening early when poor dietary intake may still be relatively easy and inexpensive to address. Screening is the first step in this identification.

Scoping review of symptoms in children with rare, progressive, life-threatening disorders

2019 ◽  
Vol 10 (1) ◽  
pp. 91-104 ◽  
Author(s):  
Colleen Pawliuk ◽  
Kim Widger ◽  
Tammie Dewan ◽  
Gina Brander ◽  
Helen L Brown ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Scoping Review ◽  
Symptom Management ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Behavioural Problems ◽  
Feeding Difficulties ◽  
Childhood Conditions ◽  
Motor Problems ◽  
Cornelia De Lange

BackgroundQ3 conditions are progressive, metabolic, neurological or chromosomal childhood conditions without a cure. Children with these conditions face an unknown lifespan as well as unstable and uncomfortable symptoms. Clinicians and other healthcare professionals are challenged by a lack of evidence for symptom management for these conditions.AimsIn this scoping review, we systematically identified and mapped the existing literature on symptom management for children with Q3 conditions. We focused on the most common and distressing symptoms, namely alertness, behavioural problems, bowel incontinence, breathing difficulties, constipation, feeding difficulties, sleep disturbance, temperature regulation, tone and motor problems and urinary incontinence. For children with complex health conditions, good symptom management is pertinent to ensure the highest possible quality of life.MethodsScoping review. Electronic database searches in Ovid MEDLINE, Embase and CINAHL and a comprehensive grey literature search.ResultsWe included 292 studies in our final synthesis. The most commonly reported conditions in the studies were Rett syndrome (n=69), followed by Cornelia de Lange syndrome (n=25) and tuberous sclerosis (n=16). Tone and motor problems were the most commonly investigated symptom (n=141), followed by behavioural problems (n=82) and sleep disturbance (n=62).ConclusionThe evidence for symptom management in Q3 conditions is concentrated around a few conditions, and these studies may not be applicable to other conditions. The evidence is dispersed in the literature and difficult to access, which further challenges healthcare providers. More research needs to be done in these conditions to provide high-quality evidence for the care of these children.

scholarly journals Identifying occupational health hazards among healthcare providers and ancillary staff in Ghana: a scoping review protocol

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e058048
Author(s):  
Philip Apraku Tawiah ◽  
Alberta Baffour-Awuah ◽  
Emmanuel Appiah-Brempong ◽  
Evans Afriyie-Gyawu
Keyword(s):  
Occupational Health ◽  
Scoping Review ◽  
Healthcare Workers ◽  
English Language ◽  
Electronic Materials ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Health And Safety ◽  
Occupational Exposures ◽  
Reference List

IntroductionThe formation, modification and implementation of occupational health and safety policy for the Ghana healthcare industry hinge on data and reviews on occupational exposures. However, there is no synthesised review to speak to the issues of these occupational exposures. A scoping review on occupational exposures among the health workforce in Ghana will provide a broad overview of exposures, and can guide and assist in making decisions on occupational health issues relating to healthcare workers.Methods and analysisArksey and O’Malley’s scoping review methodology framework will guide the conduct of this scoping review. Primary research studies, government documents and other information on occupational exposures among healthcare workers published in the English language will be retrieved from databases including PubMed, CINAHL, Embase, MEDLINE, Scopus, PsycINFO and Google scholar. A systematic search strategy will be employed to identify articles from 1 January 2010 until 30 November 2021. Also, grey literature sources in Ghana including government and tertiary institutions websites will be searched. A reference list of key studies and other available non-electronic materials will also be screened to identify relevant studies for inclusion. The review will consider studies that address prevalence, knowledge and predisposing factors of occupational exposures along with the use of occupational hazards control/preventive measures. After removal of duplicates, and title and abstract screening, relevant articles will be subjected to full-text analysis. The screening processes will be conducted independently by two reviewers. Data will then be extracted and presented in tabular form with a narrative to aid easy comprehension.Ethics and disseminationThis scoping review does not require ethical approval. The findings will be disseminated through publications, conference presentations and stakeholder meetings.

scholarly journals Primary care-based models of care for osteoarthritis: a scoping review protocol

2021 ◽  
Vol 4 ◽  
pp. 48
Author(s):  
Joice Cunningham ◽  
Frank Doyle ◽  
Jennifer M. Ryan ◽  
Barbara Clyne ◽  
Cathal Cadogan ◽  
...  
Keyword(s):  
Primary Care ◽  
Scoping Review ◽  
Grey Literature ◽  
Models Of Care ◽  
Current Evidence ◽  
Future Research ◽  
Local Health ◽  
Prevalence Of Obesity ◽  
Specific Care ◽  
Local Health System

Background: The burden of osteoarthritis (OA) to individuals and health systems is substantial and is expected to increase due to population ageing and rising prevalence of obesity and multimorbidity. Primary care-based models of care (MoCs) are being increasingly developed in response to this growing burden. However, these MoCs have yet to be formally reviewed. A MoC can be defined as an ‘evidence-informed strategy, framework or pathway that outlines the optimal manner in which condition-specific care should be delivered to consumers within a local health system’. Objective: To identify and describe the available research regarding the extent, nature and characteristics of MoCs for OA that have been developed or evaluated in primary care. Methods: A scoping review will be conducted in accordance with the Arksey and O’Malley scoping review framework and the PRISMA-ScR guidelines. Systematic literature searches of MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science and LILACs will be conducted from 2010 to present, aligning with publication dates of recent clinical guidelines. A structured iterative search of grey literature will be conducted. Full-text original quantitative or mixed method studies which describe the development or evaluation of MoCs for OA in primary care will be considered. Data will be charted and synthesised and a narrative synthesis will be conducted. Conclusions: This scoping review will provide a broad overview regarding the extent, nature and characteristics of the available literature on primary care based MoCs for OA. Findings will be used to identify gaps in the current evidence to identify areas for future research.

scholarly journals Antibiotic prescribing in UK out-of-hours primary care services: a realist-informed scoping review of training and guidelines for health care professionals

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2020.0167
Author(s):  
Paula Gomes Alves ◽  
Gail Hayward ◽  
Geraldine Leydon ◽  
Rebecca Barnes ◽  
Catherine Woods ◽  
...  
Keyword(s):  
Primary Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Clinical Guidelines ◽  
Grey Literature ◽  
Public Health Problem ◽  
Antibiotic Prescribing ◽  
Out Of Hours ◽  
Training Resources ◽  
The Uk

BackgroundAntibiotic overuse has contributed to antimicrobial resistance, a global public health problem. In the UK, despite the fall in rates of antibiotic prescription since 2013, prescribing levels remain high in comparison with other European countries. Prescribing in out of hours care (OOH) provides unique challenges for prudent prescribing, for which professionals may not be prepared.AimTo explore the guidance available to professionals on prescribing antibiotics for common infections in OOH primary care within the UK, with a focus on training resources, guidelines, and clinical recommendations.Design and methodWe carried out a realist-informed scoping review of peer-reviewed papers and grey literature focusing on antibiotic prescribing OOH (eg, clinical guidelines, training videos). General prescribing guidance was searched whenever OOH-focused resources were unavailable. Electronic databases and websites of national agencies and professional societies were searched following PRISMA standards. Findings were organised according to realist review components ie, mechanisms, contexts, and outcomes.Results46 clinical guidelines and eight training resources were identified. Clinical guidelines targeted adults and children and included recommendations on prescription strategy, spectrum of the antibiotic prescribed, communication with patients, treatment duration, and decision-making processes.ConclusionNo clinical guidelines or training resources focusing specifically on OOH were found. Our results highlight a lack of knowledge about whether existing resources address the challenges faced by OOH antibiotic prescribers. Further research is needed to explore the training needs of OOH health professionals, and whether further OOH-focused resources need to be developed given the rates of antibiotic prescribing in this setting.

Measuring integrated care at the interface between primary care and secondary care: a scoping review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Aimee O'Farrell ◽  
Geoff McCombe ◽  
John Broughan ◽  
Áine Carroll ◽  
Mary Casey ◽  
...  
Keyword(s):  
Primary Care ◽  
Scoping Review ◽  
Full Text ◽  
Secondary Care ◽  
Research Question ◽  
Grey Literature ◽  
Problem Area ◽  
Cochrane Library ◽  
Comprehensive Overview ◽  
Content Type

PurposeIn many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of disease. The interface between primary and secondary care has been identified as a problem area. This paper aims to undertake a scoping review to gain a deeper understanding of the markers of integration across the primary–secondary interface.Design/methodology/approachA search was conducted of PubMed, SCOPUS, Cochrane Library and the grey literature for papers published in English using the framework described by Arksey and O'Malley. The search process was guided by the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA).FindingsThe initial database search identified 112 articles, which were screened by title and abstract. A total of 26 articles were selected for full-text review, after which nine articles were excluded as they were not relevant to the research question or the full text was not available. In total, 17 studies were included in the review. A range of study designs were identified including a systematic review (n = 3), mixed methods study (n = 5), qualitative (n = 6) and quantitative (n = 3). The included studies documented integration across the primary–secondary interface; integration measurement and factors affecting care coordination.Originality/valueMany studies examine individual aspects of integration. However, this study is unique as it provides a comprehensive overview of the many perspectives and methodological approaches involved with evaluating integration within the primary–secondary care interface and primary care itself. Further research is required to establish valid reliable tools for measurement and implementation.

Normative Beliefs and Values Shape Mother’s Care Seeking Behaviours for Skilled Birth Attendance (Sba) During Birthing in Africa: A Scoping Review Protocol

2020 ◽  
Author(s):  
Choolwe Jacobs ◽  
Adnan Hyder
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Skilled Birth Attendance ◽  
Health Facilities ◽  
Barriers And Facilitators ◽  
Care Seeking ◽  
Normative Beliefs ◽  
Birth Attendance ◽  
Beliefs And Values ◽  
Scoping Reviews

Abstract Background: Skilled birth attendance (SBA) during delivery has been associated with improved maternal health outcome. However, low utilisation of SBA during childbirth has continued in many developing countries including Zambia. An understanding of the beliefs and values and how mothers are influenced by relational normative motivations is critical in understanding some “hidden” barriers and facilitators to utilisation of SBA in health facilities.Methods: A scoping review of normative beliefs and values shaping care seeking behaviours for Skilled Birth Attendance by mothers in Africa will be conducted. Google scholar, PubMed, EBSCOhost, SCOPUS, Embase and WEB of Science will be searched for articles that meet the eligibility criteria. The primary search will include peer-reviewed articles. Further searches will be made on Research gate, including grey literature from university websites for dissertations and theses. We will also search reference lists for relevant articles and studies. Keyword searches will be used to identify articles. Two independent reviewers will begin screening for eligible titles, abstracts and full articles with a third reviewer to help resolve any disputes. During title and abstract screening, duplicates will be removed. Study selection will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, and the Mixed Method Appraisal Tool will determine the quality of included studies. Content analysis will be used to present the narrative Discussion: Understanding how individual mother’s health seeking behaviours for SBA and those close to them are influenced by their beliefs and values is critical to informing health systems on the possible “hidden” barriers and facilitators to utilisation of SBA in public health facilities. The review will complement evidence base on normative beliefs and values shaping care seeking behaviours for Skilled Birth Attendance by mothers in Africa.

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