scholarly journals Champions for improved adherence to guidelines in long-term care homes: a systematic review

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Amanda M. Hall ◽  
Gerd M. Flodgren ◽  
Helen L. Richmond ◽  
Sheila Welsh ◽  
Jacqueline Y. Thompson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Long Term Care ◽  
Term Care ◽  
Adherence To Guidelines ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
Multicomponent Interventions

Abstract Background The champion model is increasingly being adopted to improve uptake of guideline-based care in long-term care (LTC). Studies suggest that an on-site champion may improve the quality of care residents’ health outcomes. This review assessed the effectiveness of the champion on staff adherence to guidelines and subsequent resident outcomes in LTC homes. Method This was a systematic review and meta-analyses of randomised controlled trials. Eligible studies included residents aged 65 or over and nursing staff in LTC homes where there was a stand-alone or multi-component intervention that used a champion to improve staff adherence to guidelines and resident outcomes. The measured outcomes included staff adherence to guidelines, resident health outcomes, quality of life, adverse events, satisfaction with care, or resource use. Study quality was assessed with the Cochrane Risk of Bias tool; evidence certainty was assessed using the GRADE approach. Results After screening 4367 citations, we identified 12 articles that included the results of 1 RCT and 11 cluster-RCTs. All included papers evaluated the effects of a champion as part of a multicomponent intervention. We found low certainty evidence that champions as part of multicomponent interventions may improve staff adherence to guidelines. Effect sizes varied in magnitude across studies including unadjusted risk differences (RD) of 4.1% [95% CI: − 3%, 9%] to 44.8% [95% CI: 32%, 61%] for improving pressure ulcer prevention in a bed and a chair, respectively, RD of 44% [95% CI: 17%, 71%] for improving depression identification and RD of 21% [95% CI: 12%, 30%] for improving function-focused care to residents. Conclusion Champions may improve staff adherence to evidence-based guidelines in LTC homes. However, methodological issues and poor reporting creates uncertainty around these findings. It is premature to recommend the widespread use of champions to improve uptake of guideline-based care in LTC without further study of the champion role and its impact on cost. Trial registration PROSPERO CRD42019145579. Registered on 20 August 2019.

Non-pharmacological interventions to improve constipation amongst older adults in long-term care settings: A systematic review of randomised controlled trials

2020 ◽  
Vol 41 (6) ◽  
pp. 992-999
Author(s):  
Iria Dobarrio-Sanz ◽  
José Manuel Hernández-Padilla ◽  
María Mar López-Rodríguez ◽  
Cayetano Fernández-Sola ◽  
José Granero-Molina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Randomised Controlled Trials ◽  
Long Term Care ◽  
Controlled Trials ◽  
Pharmacological Interventions ◽  
Term Care ◽  
Randomised Controlled

scholarly journals Prevalence of dementia in long-term care institutions: a meta-analysis

2021 ◽  
Vol 70 (1) ◽  
pp. 59-67
Author(s):  
Daniel Ferreira Fagundes ◽  
Marcos Túlio Costa ◽  
Bárbara Bispo da Silva Alves ◽  
Maria Madalena Soares Benício ◽  
Lanna Pinheiro Vieira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Long Term Care ◽  
Web Of Science ◽  
Meta Analysis ◽  
Term Care ◽  
Meta Analyses ◽  
Prevalence Of Dementia

ABSTRACT Objective: This study comprises a systematic review and meta-analysis that aimed to estimate the prevalence of dementia in long-term care institutions (LTCIs). Methods: We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Original transversal and longitudinal articles published until July 2020 were eligible in this review. Databases PubMed/MedLine, Web of Science, Scopus and ScienceDirect were searched. Overall prevalence and confidence intervals were estimated. Heterogeneity was calculated according to the index of heterogeneity (I2). Results: One hundred seventy-five studies were found in all databases and 19 studies were meta-analyses, resulting in an overall prevalence of 53% (CI 46-59%; p < 0.01) of demented older adults living in LTCIs. Conclusion: Prevalence of dementia is higher in older adults living in LTCIs than those living in general communities. This data shows a worrying reality that needs to be changed. There is a need for a better understanding of the elements that cause this increase in dementia in LTCFs to direct actions to improve the quality of life and health of institutionalized elderly.

scholarly journals A systematic review of the effectiveness of advanced practice nurses in long-term care

2021 ◽  
Author(s):  
Alba DiCenso
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Prospective Studies ◽  
Long Term Care ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Term Care ◽  
Practice Nurses

To report quantitative evidence of the effectiveness of advanced practice nursing roles, clinical nurse specialists and nurse practitioners, in meeting the healthcare needs of older adults living in long-term care residential settings. Although studies have examined the effectiveness of advanced practice nurses in this setting, a systematic review of this evidence has not been conducted. Quantitative systematic review. Twelve electronic databases were searched (1966-2010); leaders in the field were contacted; and personal files, reference lists, pertinent journals, and websites were searched for prospective studies with a comparison group. Studies that met inclusion criteria were reviewed for quality, using a modified version of the Cochrane Effective Practice and Organisation of Care Review Group risk of bias assessment criteria. Four prospective studies conducted in the USA and reported in 15 papers were included. Long-term care settings with advanced practice nurses had lower rates of depression, urinary incontinence, pressure ulcers, restraint use, and aggressive behaviours; more residents who experienced improvements in meeting personal goals; and family members who expressed more satisfaction with medical services. Advanced practice nurses are associated with improvements in several measures of health status and behaviours of older adults in long-term care settings and in family satisfaction. Further exploration is needed to determine the effect of advanced practice nurses on health services use; resident satisfaction with care and quality of life; and the skills, quality of care, and job satisfaction of healthcare staff.

Nursing Staff Time and Care Quality in Long-Term Care Facilities: A Systematic Review

2019 ◽  
Vol 60 (3) ◽  
pp. e200-e217 ◽  
Author(s):  
Susan Armijo-Olivo ◽  
Rodger Craig ◽  
Paula Corabian ◽  
Bing Guo ◽  
Sepideh Souri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Nursing Staff ◽  
Long Term Care ◽  
Staff Time ◽  
Term Care ◽  
Resident Care ◽  
Coverage Models

Abstract Background and Objectives In long-term care (LTC) facilities, nursing staff are important contributors to resident care and well-being. Despite this, the relationships between nursing staff coverage, care hours, and quality of resident care in LTC facilities are not well understood and have implications for policy-makers. This systematic review summarizes current evidence on the relationship between nursing staff coverage, care hours, and quality of resident care in LTC facilities. Research Design and Methods A structured literature search was conducted using four bibliographic databases and gray literature sources. Abstracts were screened by two independent reviewers using Covidence software. Data from the included studies were summarized using a pretested extraction form. The studies were critically appraised, and their results were synthesized narratively. Results The systematic searched yielded 15,842 citations, of which 54 studies (all observational) were included for synthesis. Most studies (n = 53, 98%) investigated the effect of nursing staff time on resident care. Eleven studies addressed minimum care hours and quality of care. One study examined the association between different nursing staff coverage models and resident outcomes. Overall, the quality of the included studies was poor. Discussion and Implications Because the evidence was inconsistent and of low quality, there is uncertainty about the direction and magnitude of the association between nursing staff time and type of coverage on quality of care. More rigorously designed studies are needed to test the effects of different cutoffs of care hours and different nursing coverage models on the quality of resident care in LTC facilities.

scholarly journals Determinants of the quality of care relationships in long-term care - a systematic review

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Aukelien Scheffelaar ◽  
Nanne Bos ◽  
Michelle Hendriks ◽  
Sandra van Dulmen ◽  
Katrien Luijkx
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Long Term Care ◽  
Term Care ◽  
Care Relationships

scholarly journals A systematic review of the effectiveness of advanced practice nurses in long-term care

2021 ◽  
Author(s):  
Alba DiCenso
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Prospective Studies ◽  
Long Term Care ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Term Care ◽  
Practice Nurses

To report quantitative evidence of the effectiveness of advanced practice nursing roles, clinical nurse specialists and nurse practitioners, in meeting the healthcare needs of older adults living in long-term care residential settings. Although studies have examined the effectiveness of advanced practice nurses in this setting, a systematic review of this evidence has not been conducted. Quantitative systematic review. Twelve electronic databases were searched (1966-2010); leaders in the field were contacted; and personal files, reference lists, pertinent journals, and websites were searched for prospective studies with a comparison group. Studies that met inclusion criteria were reviewed for quality, using a modified version of the Cochrane Effective Practice and Organisation of Care Review Group risk of bias assessment criteria. Four prospective studies conducted in the USA and reported in 15 papers were included. Long-term care settings with advanced practice nurses had lower rates of depression, urinary incontinence, pressure ulcers, restraint use, and aggressive behaviours; more residents who experienced improvements in meeting personal goals; and family members who expressed more satisfaction with medical services. Advanced practice nurses are associated with improvements in several measures of health status and behaviours of older adults in long-term care settings and in family satisfaction. Further exploration is needed to determine the effect of advanced practice nurses on health services use; resident satisfaction with care and quality of life; and the skills, quality of care, and job satisfaction of healthcare staff.

scholarly journals Correction to: Determinants of the quality of care relationships in long-term care – a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Aukelien Scheffelaar ◽  
Nanne Bos ◽  
Michelle Hendriks ◽  
Sandra van Dulmen ◽  
Katrien Luijkx
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Long Term Care ◽  
Term Care ◽  
Care Relationships
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