scholarly journals Measuring safety in older adult care homes: a scoping review of the international literature

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043206
Author(s):  
Stacey Rand ◽  
Nick Smith ◽  
Karen Jones ◽  
Alan Dargan ◽  
Helen Hogan
Keyword(s):  
Older Adult ◽  
English Language ◽  
Care Home ◽  
Care Homes ◽  
Journal Articles ◽  
Inclusion Criteria ◽  
Healthcare Provision ◽  
Adult Care ◽  
Quantitative Studies ◽  
Home Context

BackgroundSafety is a key concern in older adult care homes. However, it is a less developed concept in older adult care homes than in healthcare settings. As part of study of the collection and application of safety data in the care home sector in England, a scoping review of the international literature was conducted.ObjectivesThe aim of the review was to identify measures that could be used as indicators of safety for quality monitoring and improvement in older adult residential or nursing care homes.Sources of evidenceSystematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019.Eligibility criteriaInclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria.Charting methodsKey information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps.Results and conclusionsSystematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019. Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home.A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria. Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps.The findings indicate that there are a range of available safety measures used for quality monitoring and improvement in older adult care homes. These cover all five domains of safety in the SMMF. However, there are potential gaps. These include user experience, psychological harm related to the care home environment, abusive or neglectful care practice and the processes for integrated learning. Some of these gaps may relate to challenges and feasibility of measurement in the care home context.

GPs’ experience of safeguarding in care homes: what do they see and what do they do?

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711269
Author(s):  
Elisabeth Alton ◽  
Caroline White
Keyword(s):  
Online Survey ◽  
Qualitative Data ◽  
Care Home ◽  
Health Needs ◽  
Care Homes ◽  
Electronic Records ◽  
Multiple Relationships ◽  
Home Context ◽  
Emerging Themes ◽  
Multiple Health

BackgroundAbuse of older people in care homes is an on-going problem. GPs, as the most frequent practitioner group visiting care homes, have an important role in detecting and reporting abuse. However, there is little research about GPs’ experiences of working in care homes and how they work to safeguard residents.AimTo explore the challenges experienced by GPs working in this unique environment and how these impact on safeguarding.MethodAn online survey collected qualitative data about GPs’ experiences as visiting professionals to care homes, with an emphasis on safeguarding. A thematic analysis identified key themes.ResultsIn total, 58 completed surveys were returned, with a range of practitioner experience represented (1–30 years). Approximately 70% were GP partners, with the remainder salaried and locum doctors. Over one third reported they had witnessed signs of definite or possible abuse within care homes. Emerging themes related to the complex care home context, in which residents had multiple health needs and GPs had to build multiple relationships with managers, carers, families, and residents. Difficulties in accessing information were reported; residents could not always provide information, GPs had to rely on others for information, and rarely had access to electronic records.ConclusionGP work in care homes is a complex and skilled role, in which GPs encounter evidence of poor care and abuse. Key themes in respect of barriers and facilitators of good care were highlighted. The reliance on others for information and the need to build relationships with staff/managers may raise tensions in respect of safeguarding practice.

scholarly journals Research Synthesis

2019 ◽  
Vol 83 (3) ◽  
pp. 598-626 ◽  
Author(s):  
Caroline Roberts ◽  
Emily Gilbert ◽  
Nick Allum ◽  
Léïla Eisner
Keyword(s):  
Data Quality ◽  
English Language ◽  
Survey Methodology ◽  
Future Research ◽  
Journal Articles ◽  
Inclusion Criteria ◽  
Response Error ◽  
Response Strategies ◽  
Online Databases ◽  
Different Types

Abstract Herbert Simon’s (1956) concept of satisficing provides an intuitive explanation for the reasons why respondents to surveys sometimes adopt response strategies that can lead to a reduction in data quality. As such, the concept rapidly gained popularity among researchers after it was first introduced to the field of survey methodology by Krosnick and Alwin (1987), and it has become a widely cited buzzword linked to different forms of response error. In this article, we present the findings of a systematic review involving a content analysis of journal articles published in English-language journals between 1987 and 2015 that have drawn on the satisficing concept to evaluate survey data quality. Based on extensive searches of online databases, and an initial screening exercise to apply the study’s inclusion criteria, 141 relevant articles were identified. Guided by the theory of survey satisficing described by Krosnick (1991), the methodological features of the shortlisted articles were coded, including the indicators of satisficing analyzed, the main predictors of satisficing, and the presence of main or interaction effects on the prevalence of satisficing involving indicators of task difficulty, respondent ability, and respondent motivation. Our analysis sheds light on potential differences in the extent to which satisficing theory holds for different types of response error, and highlights a number of avenues for future research.

scholarly journals Current prevalence of dementia, depression and behavioural problems in the older adult care home sector: the South East London Care Home Survey

2014 ◽  
Vol 43 (4) ◽  
pp. 562-567 ◽  
Author(s):  
R. Stewart ◽  
M. Hotopf ◽  
M. Dewey ◽  
C. Ballard ◽  
J. Bisla ◽  
...  
Keyword(s):  
Older Adult ◽  
Care Home ◽  
Behavioural Problems ◽  
The South ◽  
Adult Care ◽  
Current Prevalence ◽  
Prevalence Of Dementia

scholarly journals Quality of Life in Older Adult Care Homes: Comparing Office Hours with Out-of-Office Hours

2019 ◽  
Vol 0 (2019) ◽  
pp. 153
Author(s):  
N. Smith ◽  
A.-M. Towers ◽  
S. Palmer ◽  
G. Collins
Keyword(s):  
Quality Of Life ◽  
Older Adult ◽  
Care Homes ◽  
Adult Care

scholarly journals SWARM: A regional health system’s intervention approach to COVID-19 outbreaks in nursing and adult care homes in rural eastern North Carolina

2020 ◽  
Vol 9 (4) ◽  
pp. 27
Author(s):  
Gregory D. Kearney ◽  
Pamela Cowin ◽  
Todd Hickey ◽  
Bennett Wall ◽  
Jeffrey Shovelin ◽  
...  
Keyword(s):  
North Carolina ◽  
Care Home ◽  
Care Homes ◽  
Health Concern ◽  
Adult Care ◽  
Scarce Resources ◽  
Care Facilities ◽  
Healthcare Crisis ◽  
Key Indicators ◽  
Eastern North Carolina

Background: Incessant, COVID-19 outbreaks occurring in nursing and adult care homes are a serious public health concern that continues to create significant healthcare crisis management challenges. Adult care facilities often lack in-house capacity and capability to safely treat its ill residents, while hospitals are strained to balance the influx of patients, allocate scarce resources and protect healthcare workers.Objectives: This project sought to implement a regional, community engaged, intervention model to assist nursing and adult care homes in reducing or preventing outbreaks and risks associated with COVID-19 in rural eastern North Carolina (N.C.).Methods: Design/Setting: Through collaborations between Vidant Health (VH), health departments and a network of community partners, a shared intervention plan was created and implemented to monitor nursing and adult care homes for COVID-19-related outbreaks across 29 counties in rural eastern N.C. A “Strike” team or “Swarm (SWARM) approach was developed as an operationalized concept for rapidly responding to nursing and adult care home outbreaks while providing an array of services and interventions to help prevent the spread of COVID-19. Comparative analysis was conducted between the mean number of COVID-19-related cases, deaths and length of outbreak time in VH service contracted, SWARM facilities (n = 12) and all other non-service contracted, or non-SWARM facilities (n = 155) in N.C.Results: Nursing and adult care homes under service contract using our SWARM approach experienced fewer average number of COVID-19-related resident ill cases (24.4 vs 29.0), and deaths (1.2 vs. 3.9). The length of outbreak recovery time was far less among SWARM facilities than non-participating, non-SWARM facilities (17.1 vs. 25.4; p < .034).Conclusions: By actively monitoring key indicators, engaging in daily communication with local partners and providing rapid response, VH’s SWARM approach provides a proactive method for preventing further spread of COVID-19 in adult care facilities and communities.

scholarly journals Improving the Quality of Care in Care Homes Using the Quality Improvement Collaborative Approach: Lessons Learnt from Six Projects Conducted in the UK and The Netherlands

2020 ◽  
Vol 17 (20) ◽  
pp. 7601 ◽  
Author(s):  
Reena Devi ◽  
Graham Martin ◽  
Jay Banerjee ◽  
Louise Butler ◽  
Tim Pattison ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Care Home ◽  
Care Homes ◽  
Collaborative Teams ◽  
Quality Improvement Collaborative ◽  
Team Members ◽  
Job Roles ◽  
Healthcare Settings ◽  
Home Context ◽  
The Uk

The Breakthrough Series Quality Improvement Collaborative (QIC) initiative is a well-developed and widely used approach, but most of what we know about it has come from healthcare settings. In this article, those leading QICs to improve care in care homes provide detailed accounts of six QICs and share their learning of applying the QIC approach in the care home sector. Overall, five care home-specific lessons were learnt: (i) plan for the resources needed to support collaborative teams with collecting, processing, and interpreting data; (ii) create encouraging and safe working environments to help collaborative team members feel valued; (iii) recruit collaborative teams, QIC leads, and facilitators who have established relationships with care homes; (iv) regularly check project ideas are aligned with team members’ job roles, responsibilities, and priorities; and (v) work flexibly and accept that planned activities may need adapting as the project progresses. These insights are targeted at teams delivering QICs in care homes. These insights demonstrate the need to consider the care home context when applying improvement tools and techniques in this setting.

scholarly journals Protocol for a realist review of General Practitioners’ Role in Advancing Practice in Care Homes (GRAPE study)

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036221 ◽  
Author(s):  
Adam L Gordon ◽  
Reena Devi ◽  
Christopher Williams ◽  
Claire Goodman ◽  
Kathleen Sartain ◽  
...  
Keyword(s):  
General Practitioners ◽  
Care Home ◽  
Realist Review ◽  
Healthcare Services ◽  
Care Homes ◽  
Healthcare Provision ◽  
Care Home Staff ◽  
Research Journal ◽  
Experience Of Care ◽  
Literature Searches

IntroductionOlder people who live in care homes have a high level of need with complex health conditions. In addition to providing medical care to residents, general practitioners (GPs) play a role as gatekeeper for access to services, as well as leadership within healthcare provision. This review will describe how GPs were involved in initiatives to change arrangements of healthcare services in order to improve quality and experience of care.Methods and analysisFollowing RAMESES quality and publication guidelines standards, we will proceed with realist review to develop theories of how GPs work with care home staff to bring about improvements. We identify when improvement in outcomes does not occur and why this may be the case. The first stage will include interviews with GPs to ask their views on improvement in care homes. These interviews will enable development of initial theories and give direction for the literature searches. In the second stage, we will use iterative literature searches to add depth and context to the early theories; databases will include Medline, Embase, CINAHL, PsycINFO and ASSIA. In stage 3, evidence that is judged as rigorous and relevant will be used to test the initial theories, and through the process, refine the theory statements. In the final stage, we will synthesise findings and provide recommendations for practice and policy-making.During the review, we will invite a context expert group to reflect on our findings. This group will have expertise in current trends in primary care and the care home sector both in UK and internationally.Ethics and disseminationThe study was approved by University of Nottingham Faculty of Medicine and Health Sciences Research Ethics Committee: 354-1907. Findings will be shared through stakeholder networks, published in National Institute for Health Research journal and submitted for peer-reviewed journal publication.

scholarly journals The Subtle and Silent Issue in Older Adult Care

2021 ◽  
Vol 11 (S1) ◽  
Author(s):  
Sarah Fu
Keyword(s):  
Older Adult ◽  
Elderly Population ◽  
Long Term Care ◽  
The Elderly ◽  
Care Homes ◽  
Medical Community ◽  
Adult Care ◽  
Term Care ◽  
Poor Treatment

The treatment of elders in the community and ageism in our society has been an issue often underlooked. However, since the onset of the COVID-19 pandemic, poor treatment of elders in the community and long term care homes has been brought to light. During the beginning of the pandemic, long term care homes in Canada accounted for around 80% of all COVID-19 related mortalities [1]. This situation is due to an amalgamation of factors leading towards the ultimate neglect of the elderly population, including the governance of long term care homes in Canada, the stigma against the elderly population, and the commonly misconceived clinical picture of a ‘frail’ senior by the medical community.

scholarly journals Prevalence of Depression, Anxiety, and Stress during COVID-19 Pandemic

2020 ◽  
Vol 11 (04) ◽  
pp. 519-525 ◽  
Author(s):  
Ram Lakhan ◽  
Amit Agrawal ◽  
Manoj Sharma
Keyword(s):  
Mental Health ◽  
English Language ◽  
Mental Health Problems ◽  
Sleep Problems ◽  
Health Problems ◽  
Global Level ◽  
Journal Articles ◽  
Inclusion Criteria ◽  
Prevalence Of Depression ◽  
Study Population

AbstractThe coronavirus disease 2019 (COVID-19) crisis has greatly affected human lives across the world. Uncertainty and quarantine have been affecting people’s mental health. Estimations of mental health problems are needed immediately for the better planning and management of these concerns at a global level. A rapid scoping review was conducted to get the estimation of mental health problems in the COVID-19 pandemic during the first 7 months. Peer-reviewed, data-based journal articles published in the English language were searched in the PubMed, Medline, and Google Scholar electronic databases from December 2019 to June 2020. Papers that met the inclusion criteria were analyzed and discussed in this review. A total of 16 studies were included. Eleven studies were from China, two from India, and one from Spain, Italy, and Iran. Prevalence of all forms of depression was 20%, anxiety 35%, and stress 53% in the combined study population of 113,285 individuals. The prevalence rate of all forms of depression, anxiety, stress, sleep problems, and psychological distress in general population was found to be higher during COVID-19 pandemic.

scholarly journals Exploring factors that affect the uptake and sustainability of videoconferencing for healthcare provision for older adults in care homes: a realist evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Louise Newbould ◽  
Steven Ariss ◽  
Gail Mountain ◽  
Mark S. Hawley
Keyword(s):  
Older Adults ◽  
Care Home ◽  
Realist Evaluation ◽  
Care Homes ◽  
Successful Implementation ◽  
Healthcare Provision ◽  
Home Culture ◽  
Factors Affecting ◽  
Care Home Staff ◽  
Remote Healthcare

Abstract Background Videoconferencing has been proposed as a way of improving access to healthcare for older adults in care homes. Despite this, effective uptake of videoconferencing remains varied. This study evaluates a videoconferencing service for care home staff seeking support from healthcare professionals for the care of residents. The aim was to explore factors affecting the uptake and sustainability of videoconferencing in care homes, to establish what works for whom, in which circumstances and respects. The findings informed recommendations for commissioners and strategic managers on how best to implement videoconferencing for remote healthcare provision in care homes for older adults. Methods Realist evaluation was used to develop, refine and test theories around the uptake and maintenance of videoconferencing in three care homes across Yorkshire and the Humber, England. The care homes were selected using maximum variation sampling regarding the extent to which they used videoconferencing. A developmental inquiry framework and realist interviews were used to identify Context, Mechanism and Outcome Configurations (CMOCs) regarding uptake and sustainability of the service. Participants included care home residents (aged > 65) and staff, relatives and strategic managers of care home chains. The interviews were an iterative process conducted alongside data analysis. Transcripts of audio recordings were entered into NVIVO 12, initially coded into themes, then hypotheses developed, refined and tested. Results Outcomes were generated in relation to two main contextual factors, these were: (1) communication culture in the home and (2) the prior knowledge and experience that staff have of videoconferencing. The key facilitators identified were aspects of leadership, social links within the home and psychological safety which promoted shared learning and confidence in using the technology. Conclusions Videoconferencing is a valuable tool, but successful implementation and sustainability are dependent on care home culture and staff training to promote confidence through positive and supported experiences.

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