scholarly journals Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine Waldron ◽  
Joan Cahill ◽  
Sam Cromie ◽  
Tim Delaney ◽  
Sean P. Kennelly ◽  
...  
Keyword(s):  
Medication Reconciliation ◽  
Positive Impact ◽  
Data Extraction ◽  
Care Transitions ◽  
Theory Development ◽  
Realist Review ◽  
Electronic Records ◽  
Reduce Medication Error ◽  
Realist Methodology ◽  
Rapid Realist Review

Abstract Background Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the ‘real world’. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. Methodology We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. Results Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). Conclusions This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity.

scholarly journals Personal Electronic Records of Medications (PERMs) for Medication Reconciliation at Care Transitions: A Rapid Realist Review

2021 ◽  
Author(s):  
Catherine Waldron ◽  
Joan Cahill ◽  
Sam Cromie ◽  
Tim Delaney ◽  
Sean P. Kennelly ◽  
...  
Keyword(s):  
Medication Reconciliation ◽  
Positive Impact ◽  
Data Extraction ◽  
Care Transitions ◽  
Theory Development ◽  
Realist Review ◽  
Electronic Records ◽  
Reduce Medication Error ◽  
Realist Methodology ◽  
Rapid Realist Review

Abstract Background: Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the ‘real world’. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. Methodology: We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. Results: Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). Conclusions: This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity.

scholarly journals Factors in multiple behaviour change interventions affecting smoking cessation success: a rapid realist review.

2020 ◽  
Author(s):  
Nadia Minian ◽  
Tricia Corrin ◽  
Mathangee Lingam ◽  
Wayne K deRuiter ◽  
Terri Rodak ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Behaviour Change ◽  
Data Extraction ◽  
Work Productivity ◽  
Realist Review ◽  
Risk Behaviours ◽  
Behaviour Change Interventions ◽  
The Individual ◽  
Multiple Health ◽  
Rapid Realist Review

Abstract Background Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about what components of these interventions help to promote successful smoking cessation . The aim of this rapid realist review was to identify possible mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with effectively changing tobacco use. Methods This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis. Results Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.’s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant’s capability or motivation to make a behaviour change was only successful within certain contexts. Conclusion In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from ‘individualistic epidemiology’ and invest resources into modifying factors that exist outside of the individual (i.e. creating a supportive environment). Study registration PROSPERO registration number: CRD42017064430

scholarly journals Quality care metrics (QC-M) in nursing and midwifery care processes: a rapid realist review (RRR) protocol

2020 ◽  
Vol 3 ◽  
pp. 85
Author(s):  
Laserina O'Connor ◽  
Alice Coffey ◽  
Veronica Lambert ◽  
Mary Casey ◽  
Martin McNamara ◽  
...  
Keyword(s):  
Data Extraction ◽  
Quality Care ◽  
Realist Review ◽  
Care Process ◽  
Programme Theory ◽  
Ethical Approval ◽  
Local Reference ◽  
Review Protocol ◽  
Health Nursing ◽  
Rapid Realist Review

Background: In 2018, the Office of the Nursing and Midwifery Services Director (ONMSD) completed phase one of work which culminated in the development and launch of seven research reports with defined suites of quality care process metrics (QC-Ms) and respective indicators for the practice areas – acute care, midwifery, children’s, public health nursing, older persons, mental health and intellectual disability nursing in Ireland. This paper presents a rapid realist review protocol that will systematically review the literature that examines QC-M in practice; what worked, or did not work for whom, in what contexts, to what extent, how and why? Methods: The review will explore if there are benefits of using the QC-Ms and what are the contexts in which these mechanisms are triggered. The essence of this rapid realist review is to ascertain how a change in context generates a particular mechanism that produces specific outcomes. A number of steps will occur including locating existing theories on implementation of quality care metrics, searching the evidence, selecting relevant documents, data extraction, validation of findings, synthesising and refining programme theory. This strategy may help to describe potential consequences resulting from changes in context and their interactions with mechanisms. Initial theories will be refined throughout the process by the local reference panel, comprised of eight key intervention stakeholders, knowledge users such as healthcare professionals and an expert panel. Ethical approval is not required for this rapid realist review. Conclusion: It is anticipated that the final programme theory will help to explain how QC-Ms work in practice; for whom, why and in what circumstances. Findings of this review could help to give insights into realism as a framework and how nursing and midwifery QC-Ms have been implemented previously.

scholarly journals Quality care process metrics (QCP-Ms) in nursing and midwifery care processes: a rapid realist review (RRR) protocol

2021 ◽  
Vol 3 ◽  
pp. 85
Author(s):  
Laserina O'Connor ◽  
Alice Coffey ◽  
Veronica Lambert ◽  
Mary Casey ◽  
Martin McNamara ◽  
...  
Keyword(s):  
Data Extraction ◽  
Quality Care ◽  
Realist Review ◽  
Care Process ◽  
Programme Theory ◽  
Ethical Approval ◽  
Local Reference ◽  
Process Metrics ◽  
Health Nursing ◽  
Rapid Realist Review

Background: In 2018, the Office of the Nursing and Midwifery Services Director (ONMSD) completed phase one of work which culminated in the development and launch of seven research reports with defined suites of quality care process metrics (QCP-Ms) and respective indicators for the practice areas – acute care, midwifery, children’s, public health nursing, older persons, mental health and intellectual disability nursing in Ireland. This paper presents a rapid realist review protocol that will systematically review the literature that examines QCP-Ms in practice; what worked, or did not work for whom, in what contexts, to what extent, how and why? Methods: The review will explore if there are benefits of using the QCP-Ms and what are the contexts in which these mechanisms are triggered. The essence of this rapid realist review is to ascertain how a change in context generates a particular mechanism that produces specific outcomes. A number of steps will occur including locating existing theories on implementation of quality care metrics, searching the evidence, selecting relevant documents, data extraction, validation of findings, synthesising and refining programme theory. This strategy may help to describe potential consequences resulting from changes in context and their interactions with mechanisms. Initial theories will be refined throughout the process by the local reference panel, comprised of eight key intervention stakeholders, knowledge users such as healthcare professionals and an expert panel. Ethical approval is not required for this rapid realist review. Conclusion: It is anticipated that the final programme theory will help to explain how QCP-Ms work in practice; for whom, why and in what circumstances. Findings of this review could help to give insights into the use of a rapid realist review as a framework and how nursing and midwifery QCP-Ms have been implemented previously.

scholarly journals What Works in Implementing Patient Decision Aids in Routine Clinical Settings? A Rapid Realist Review and Update from the International Patient Decision Aid Standards Collaboration

2020 ◽  
pp. 0272989X2097820
Author(s):  
Natalie Joseph-Williams ◽  
Purva Abhyankar ◽  
Laura Boland ◽  
Paulina Bravo ◽  
Alison T. Brenner ◽  
...  
Keyword(s):  
Decision Aids ◽  
Theory Development ◽  
Implementation Strategies ◽  
Realist Review ◽  
Clinical Settings ◽  
Clinical Implementation ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Implementation Studies ◽  
Rapid Realist Review

Background Decades of effectiveness research has established the benefits of using patient decision aids (PtDAs), yet broad clinical implementation has not yet occurred. Evidence to date is mainly derived from highly controlled settings; if clinicians and health care organizations are expected to embed PtDAs as a means to support person-centered care, we need to better understand what this might look like outside of a research setting. Aim This review was conducted in response to the IPDAS Collaboration’s evidence update process, which informs their published standards for PtDA quality and effectiveness. The aim was to develop context-specific program theories that explain why and how PtDAs are successfully implemented in routine healthcare settings. Methods Rapid realist review methodology was used to identify articles that could contribute to theory development. We engaged key experts and stakeholders to identify key sources; this was supplemented by electronic database (Medline and CINAHL), gray literature, and forward/backward search strategies. Initial theories were refined to develop realist context-mechanism-outcome configurations, and these were mapped to the Consolidated Framework for Implementation Research. Results We developed 8 refined theories, using data from 23 implementation studies (29 articles), to describe the mechanisms by which PtDAs become successfully implemented into routine clinical settings. Recommended implementation strategies derived from the program theory include 1) co-production of PtDA content and processes (or local adaptation), 2) training the entire team, 3) preparing and prompting patients to engage, 4) senior-level buy-in, and 5) measuring to improve. Conclusions We recommend key strategies that organizations and individuals intending to embed PtDAs routinely can use as a practical guide. Further work is needed to understand the importance of context in the success of different implementation studies.

scholarly journals Conversations about FGM in primary care: a realist review on how, why and under what circumstances FGM is discussed in general practice consultations

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e039809
Author(s):  
Sharon Dixon ◽  
Claire Duddy ◽  
Gabrielle Harrison ◽  
Chrysanthi Papoutsi ◽  
Sue Ziebland ◽  
...  
Keyword(s):  
Primary Care ◽  
Grey Literature ◽  
Relevant Literature ◽  
Theory Development ◽  
Realist Review ◽  
Primary Outcome Measure ◽  
Mandatory Reporting ◽  
Programme Theory ◽  
Genital Mutilation ◽  
The Impact

ObjectivesLittle is known about the management of female genital mutilation (FGM) in primary care. There have been significant recent statutory changes relevant to general practitioners (GPs) in England, including a mandatory reporting duty. We undertook a realist synthesis to explore what influences how and when GPs discuss FGM with their patients.SettingPrimary care in England.Data sourcesRealist literature synthesis searching 10 databases with terms: GPs, primary care, obstetrics, gynaecology, midwifery and FGM (UK and worldwide). Citation chasing was used, and relevant grey literature was included, including searching FGM advocacy organisation websites for relevant data. Other potentially relevant literature fields were searched for evidence to inform programme theory development. We included all study designs and papers that presented evidence about factors potentially relevant to considering how, why and in what circumstances GPs feel able to discuss FGM with their patients.Primary outcome measureThis realist review developed programme theory, tested against existing evidence, on what influences GPs actions and reactions to FGM in primary care consultations and where, when and why these influences are activated.Results124 documents were included in the synthesis. Our analysis found that GPs need knowledge and training to help them support their patients with FGM, including who may be affected, what needs they may have and how to talk sensitively about FGM. Access to specialist services and guidance may help them with this role. Reporting requirements may complicate these conversations.ConclusionsThere is a pressing need to develop (and evaluate) training to help GPs meet FGM-affected communities’ health needs and to promote the accessibility of primary care. Education and resources should be developed in partnership with community members. The impact of the mandatory reporting requirement and the Enhanced Dataset on healthcare interactions in primary care warrants evaluation.PROSPERO registration numberCRD42018091996.

scholarly journals Rapid Realist Review of School-Based Physical Activity Interventions in 7- to 11-Year-Old Children

Children ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 52
Author(s):  
Emmanuel Defever ◽  
Michelle Jones
Keyword(s):  
Physical Activity ◽  
School Leadership ◽  
School Environment ◽  
Meta Analysis ◽  
Implementation Fidelity ◽  
Realist Review ◽  
School Level ◽  
School Settings ◽  
Physical Activity Interventions ◽  
Rapid Realist Review

Meta-analysis of physical activity interventions in school settings have revealed low efficacy and that there is a need to explore implementation fidelity. The aim of this rapid realist review was to determine, what physical activity interventions in school settings for children aged 7- to 11-years-old works, for whom, and in what circumstances. The realist synthesis was conducted following RAMESES guidelines. Relevant studies were identified following a systematic search process and data from 28 studies was extracted for evidence to form context-mechanism-outcome configurations that were clustered and refined. Using the five-level socioecological model, the program theories were classified into the levels of intrapersonal (child), interpersonal (teachers), institutional (program content, school administration, and school environment), community (home and neighborhood), and policy. The school level led to most context-mechanism-outcome configurations related to school leadership and policy, workforce structure, program characteristics, and school environment. At each level, we identified features of interventions, alongside implementation considerations that might work to promote efficacy and sustainability. The need to recognize the school environment as part of a complex system with multi-level interaction and influences was a key finding. In line with realist philosophy, the researchers encouraged primary research to confirm, refute, and refine the program theories presented.

scholarly journals A Rapid Realist Review of Group Psychological First Aid for Humanitarian Workers and Volunteers

2021 ◽  
Vol 18 (4) ◽  
pp. 1452
Author(s):  
Julia Corey ◽  
Frédérique Vallières ◽  
Timothy Frawley ◽  
Aoife De Brún ◽  
Sarah Davidson ◽  
...  
Keyword(s):  
Research Question ◽  
Grey Literature ◽  
Age Groups ◽  
Integrated Design ◽  
Realist Review ◽  
First Aid ◽  
Psychological Consequences ◽  
Post Traumatic Stress ◽  
Psychological First Aid ◽  
Rapid Realist Review

Humanitarian workers are at an elevated risk of occupational trauma exposure and its associated psychological consequences, and experience increased levels of anxiety, depression, and post-traumatic stress disorder (PTSD) compared to the general population. Psychological first aid (PFA) aims to prevent acute distress reactions from developing into long-term distress by instilling feelings of safety, calmness, self- and community efficacy, connectedness and hope. Group PFA (GPFA) delivers PFA in a group or team setting. This research sought to understand ‘What works, for whom, in what context, and why for group psychological first aid for humanitarian workers, including volunteers?’ A rapid realist review (RRR) was conducted. Initial theories were generated to answer the question and were subsequently refined based on 15 documents identified through a systematic search of databases and grey literature, in addition to the inputs from a core reference panel and two external experts in GPFA. The findings generated seven programme theories that addressed the research question and offered consideration for the implementation of GPFA for the humanitarian workforce across contexts and age groups. GPFA enables individuals to understand their natural reactions, develop adaptive coping strategies, and build social connections that promote a sense of belonging and security. The integrated design of GPFA ensures that individuals are linked to additional supports and have their basic needs addressed. While the evidence is sparce on GPFA, its ability to provide support to humanitarian workers is promising.

Facts or gut feelings: analysis of external pricing antecedents for SMEs in Germany

2018 ◽  
Vol 25 (6) ◽  
pp. 886-901
Author(s):  
Lars Hendrik Achterberg ◽  
Maktoba Omar ◽  
Ambisisis Ambituuni ◽  
Oliver Roll
Keyword(s):  
Information Acquisition ◽  
Large Scale ◽  
Positive Impact ◽  
Small And Medium Enterprises ◽  
Theory Development ◽  
Knowledge Generation ◽  
Content Type ◽  
Strategic Pricing ◽  
Gut Feelings ◽  
Medium Enterprises

Purpose The purpose of this paper is to analyse the external antecedents of pricing information acquisition in an integrative manner. The study develops understanding of determinants of information acquisition as a crucial prerequisite of successful pricing strategies within German small and medium enterprises (SMEs). Design/methodology/approach A large scale survey of sampled 2,542 SMEs was conducted. A total of 220 questionnaires were completed, reflecting a response rate of 9 per cent. This was acceptable considering the sensitivity of pricing issues. A final sample of 173 usable questionnaires were obtained. Findings The result indicates that external antecedents of pricing information acquisition practices have a positive impact on SME pricing performance, and pricing performance is positively related to firm performance. Practical implications The study indicates that external antecedents of pricing information acquisition are strategic pricing capabilities, which should receive attention by SME managers. Originality/value This study bridges significant obstacle to knowledge generation and theory development of the important issues of pricing information acquisition in SMEs.

A Systematic Review of the Needs of Dementia Caregivers Across Care Settings

2021 ◽  
pp. 108482232110569
Author(s):  
Anne Mueller ◽  
Lesley Thao ◽  
Olivia Condon ◽  
Daniel Liebzeit ◽  
Beth Fields
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Care Setting ◽  
Data Extraction ◽  
Care Transitions ◽  
Quality Criteria ◽  
Term Care ◽  
Complex Needs ◽  
Memory Care ◽  
The U.S

The U.S. population of older adults living with dementia is projected to double by 2060. They rely on over 16 million family and unpaid caregivers to provide for their increasingly complex needs and care transitions. Caregivers frequently feel underprepared and without adequate support or access to resources. This systematic review seeks to identify the needs of family and unpaid caregivers of older adults living with dementia across various care settings in the U.S. A systematic search was conducted to identify articles pertaining to the needs of caregivers of older adults living with dementia. The data extraction tool was developed using aspects from the Care Transitions Framework and the Family Caregiver Alliance. Data were organized based on 3 domains of caregiver needs and the care setting(s) of the older adults living with dementia and their caregivers. A total of 31 articles were eligible for inclusion. The majority met the MMAT screening criteria, but more than half only met 2 or less of the 5 quality criteria. Caregivers’ needs were identified in the care settings of home/community-residing, assisted living, long-term care, skilled nursing, and memory care. Most articles either did not specify a care setting or included more than 1 and did not report the findings separately. Caregivers in each care setting, except memory care, identified needs in all 3 of the following domains: (1) social support—formal and informal, (2) confidence, competence, and strengths in the caregiving role, and (3) values and preferences.

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