Dehydration and Malnutrition in Residential Care: Recommendations for Strategies for Improving Practice Derived from a Scoping Review of Existing Policies and Guidelines

Preventing malnutrition and dehydration in older care home residents is a complex task, with both conditions remaining prevalent, despite numerous guidelines spanning several decades. This policy-mapping scoping review used snowballing search methods to locate publicly-available policies, reports and best practice guidelines relating to hydration and nutrition in UK residential care homes, to describe the existing knowledge base and pinpoint gaps in practice, interpretation and further investigation. The findings were synthesised narratively to identify solutions. Strategies for improvements to nutritional and hydration care include the development of age and population-specific nutrient and fluid intake guidelines, statutory regulation, contractual obligations for commissioners, appropriate menu-planning, the implementation and auditing of care, acknowledgment of residents’ eating and drinking experiences, effective screening, monitoring and treatment and staff training. The considerable body of existing knowledge is failing to influence practice, relating to translational issues of implementing knowledge into care at the point of delivery, and this is where future research and actions should focus.

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Dehydration and Malnutrition in Residential Care: Recommendations for Strategies for Improving Practice Derived from a Scoping Review of Existing Policies and Guidelines

10.20944/preprints201810.0243.v1 ◽

2018 ◽

Author(s):

Diane Bunn ◽

Lee Hooper ◽

Ailsa Welch

Keyword(s):

Residential Care ◽

Scoping Review ◽

Best Practice ◽

Care Home ◽

Future Research ◽

Menu Planning ◽

Best Practice Guidelines ◽

Contractual Obligations ◽

Statutory Regulation ◽

Considerable Body

Preventing malnutrition and dehydration in older care home residents is complex, with both conditions remaining prevalent, despite numerous guidelines spanning several decades. This policy-mapping scoping review used snowballing search methods to locate publicly-available policies, reports and best practice guidelines relating to hydration and nutrition in UK residential care homes, to describe the existing knowledge base and pinpoint gaps in practice, interpretation and further investigation. Findings were synthesised narratively to identify solutions. Strategies for improvements to nutritional and hydration care include: development of age and population-specific nutrient and fluid intake guidelines; statutory regulation, contractual obligations for commissioners, appropriate menu-planning, implementation and auditing of care, acknowledgment of residents’ eating and drinking experiences, effective screening, monitoring and treatment and staff training. The considerable body of existing knowledge is failing to influence practice, relating to translational issues of implementing knowledge into care at the point of delivery, and this is where future research and actions should focus.

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Dysphagia Therapy in Adults with a Tracheostomy: A Scoping Review Protocol

10.21203/rs.3.rs-593909/v2 ◽

2021 ◽

Author(s):

Waiza Kadri ◽

Rhiannon Halfpenny ◽

Breege Whiten ◽

Christina Smith ◽

Siofra Mulkerrin

Keyword(s):

Scoping Review ◽

Best Practice ◽

Data Extraction ◽

Grey Literature ◽

Therapeutic Interventions ◽

Current Evidence ◽

Future Research ◽

Limited Information ◽

Best Practice Guidelines ◽

Dysphagia Therapy

Abstract Background Swallowing impairment (dysphagia) and tracheostomy coexist. Research in this area has often provided an overview of dysphagia management as a whole, but there is limited information pertaining to specific dysphagia therapy in the tracheostomy population. The aim of this scoping review is to provide detailed exploration of the literature with regards to dysphagia therapeutic interventions in adults with a tracheostomy. The scoping review will describe current evidence and thus facilitate future discussions to guide clinical practice.Methods A scoping review using the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews guideline will be used. Ten electronic databases from inception to July 2021and grey literature will be searched. From identified texts forward and backward citation chasing will be completed. Data extraction will compose of population demographics, aetiology and dysphagia therapy (type, design, dose and intensity). Number of citations and papers included into the scoping review will be presented visually.Discussion The scoping review aims to expand upon the existing literature in this field. A detailed description of the evidence is required to facilitate clinical discussions and develop therapeutic protocols in a tracheostomised population. The results of this scoping review will support future research in dysphagia therapy and provide the basis for development of best practice guidelines.

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Determinants of Managed Entry Agreements in the context of Health Technology Assessment: a comparative analysis of oncology therapies in four countries

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462321000039 ◽

2021 ◽

Vol 37 ◽

Author(s):

Olina Efthymiadou ◽

Panos Kanavos

Keyword(s):

Decision Making ◽

Health Technology Assessment ◽

Technology Assessment ◽

Best Practice ◽

Health Technology ◽

Future Research ◽

Best Practice Guidelines ◽

Chi Squared ◽

Decision Making Factors ◽

Managed Entry Agreements

Abstract Background Managed Entry Agreements (MEAs) are increasingly used to address uncertainties arising in the Health Technology Assessment (HTA) process due to immature evidence of new, high-cost medicines on their real-world performance and cost-effectiveness. The literature remains inconclusive on the HTA decision-making factors that influence the utilization of MEAs. We aimed to assess if the uptake of MEAs differs between countries and if so, to understand which HTA decision-making criteria play a role in determining such differences. Methods All oncology medicines approved since 2009 in Australia, England, Scotland, and Sweden were studied. Four categories of variables were collected from publicly available HTA reports of the above drugs: (i) Social Value Judgments (SVJs), (ii) Clinical/Economic evidence submitted, (iii) Interpretation of this evidence, and (iv) Funding decision. Conditional/restricted decisions were coded as Listed With Conditions (LWC) other than an MEA or LWC including an MEA (LWCMEA). Cohen's κ-scores measured the inter-rater agreement of countries on their LWCMEA outcomes and Pearson's chi-squared tests explored the association between HTA variables and LWCMEA outcomes. Results A total of 74 drug-indication pairs were found resulting in n = 296 observations; 8 percent (n = 23) were LWC and 55 percent (n = 163) were LWCMEA. A poor-to-moderate agreement existed between countries (−.29 < κ < .33) on LWCMEA decisions. Cross-country differences within the LWCMEA sample were partly driven by economic uncertainties and largely driven by SVJs considered across agencies. Conclusions A set of HTA-related variables driving the uptake of MEAs across countries was identified. These findings can be useful in future research aimed at informing country-specific, “best-practice” guidelines for successful MEA implementation.

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Improving breastfeeding support through the implementation of the baby friendly hospital and community initiatives: a scoping review protocol

HRB Open Research ◽

10.12688/hrbopenres.13180.2 ◽

2021 ◽

Vol 4 ◽

pp. 1

Author(s):

Aisling Walsh ◽

Pieternella Pieterse ◽

Zoe McCormack ◽

Ellen Chirwa ◽

Anne Matthews

Keyword(s):

Scoping Review ◽

Best Practice ◽

Descriptive Analysis ◽

World Health ◽

Current Evidence ◽

Future Research ◽

Breastfeeding Support ◽

Quantitative Descriptive Analysis ◽

Global Campaign ◽

Scoping Reviews

Background: Improved breastfeeding practices have the potential to save the lives of over 823,000 children under 5 years old globally every year. Exclusively breastfeeding infants for the first six months would lead to the largest infant mortality reduction. The Baby-Friendly Hospital Initiative (BFHI) is a global campaign by the World Health Organization and the United Nations Children's Fund (UNICEF), which promotes best practice to support breastfeeding in maternity services. The Baby-Friendly Community Initiative (BFCI) is an extension of the BHFI’s 10 th step of the Ten Steps to Successful Breastfeeding and of the BFHI overall. Its focus is on community-based breastfeeding supports for women. There have been no known attempts to synthesise the overall body of evidence on the BFHI in recent years, and no synthesis of empirical research on the BFCI. This scoping review asks the question: what is known about the implementation of the BFHI and the BFCI globally? Methods and analysis: This scoping review will be conducted according to the Joanna Briggs Institute methodology for scoping reviews. Inclusion criteria will follow the Population, Concepts, Contexts approach. A data charting form will be developed and applied to all the included articles. Qualitative and quantitative descriptive analysis will be undertaken. The PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) methodological framework will be used to analyse and report review findings. Conclusion: This review will establish gaps in current evidence which will inform areas for future research in relation to this global initiative.

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Mental Illness Self-Stigma in Young People: A Scoping Review Protocol

10.1101/2021.07.06.21260070 ◽

2021 ◽

Author(s):

Rachel S Taylor ◽

Nicola Cogan ◽

Pamela Jenkins ◽

Xi Liu ◽

Paul S Flowers ◽

...

Keyword(s):

Mental Illness ◽

Young People ◽

Scoping Review ◽

Help Seeking ◽

Best Practice ◽

Negative Impact ◽

Future Research ◽

Primary Research ◽

Screening Process ◽

Negative Stereotypes

Background: Self-stigma (the internalisation of negative stereotypes) is known to reduce help-seeking behaviours and treatment adherence in people who have a mental illness, resulting in worsening health outcomes. Moreover, self-stigma diminishes self-esteem and self-efficacy, and leads to higher levels of depression. Half of all lifetime cases of mental illness have manifested by the age of 14, and therefore young people are vulnerable to the negative impact of suffering mental illness self-stigma. While literature in this field has been flourishing in recent years, mental illness self-stigma remains poorly understood in youth. It is important that we seek to understand what is currently known about mental illness self-stigma in young people, and subsequently use this information to guide future research to advance knowledge of this topic. To date, a scoping review which maps the available literature on mental illness self-stigma in young people has yet to be conducted. Here, we outline the protocol for a scoping review on mental illness self-stigma in young people. Methods: This protocol outlines the process of conducting a scoping review of primary research concerning mental illness self-stigma in young people. The Joanna Briggs Institute guidance on best practice for conducting a scoping review will utilised throughout. A systematic search of appropriate databases will be conducted which will allow for a two-step screening process and data charting. Inclusion criteria for this review dictates that eligible studies will i) include a population within the age range of 10-35 (or mean age within this range), ii) include the term self-stigma or internalised stigma relating to mental health/illness/disorder, iii) be primary research, iv) be published post-2009 (following the seminal study by Moses, 2009) and v) be published in English. Discussion: The findings of the scoping review outlined in this protocol will be used to inform future research which aims to explore self-stigmatising attitudes and beliefs of young people experiencing mental illness. This research will result in co-produced, impactful resources for young people on the topic of mental illness self-stigma with the aim of raising awareness and stigma reduction.

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Assessing the Veracity of Children’s Forensic Interviews

10.1093/oso/9780190612016.003.0006 ◽

2017 ◽

Author(s):

Hayden M. Henderson ◽

Samantha J. Andrews

Keyword(s):

Content Analysis ◽

Practice Guidelines ◽

Best Practice ◽

Field Research ◽

Reality Monitoring ◽

Future Research ◽

Forensic Interviews ◽

Interview Protocol ◽

Investigative Interview ◽

Best Practice Guidelines

This chapter discusses the various ways in which the veracity of children’s forensic interviews can be assessed, and the implications this diversity has for the courtroom. Beforehand, it summarizes the capabilities and vulnerabilities children bring to forensic settings, and then what constitutes veracity, the importance this concept has in legal settings, and how it is typically measured. Reality Monitoring (RM) and Criteria-Based Content Analysis (CBCA) are reviewed alongside experimental and field research designed to elucidate the ways in which interview “quality” can be improved. The usefulness of best practice guidelines, such as the NICHD Investigative Interview Protocol, in assessing quality is considered. Difficulties for translating research into practice are discussed. The implications these factors have for the examination of children in court are then considered, and the experimental and field research is reviewed. The chapter ends by outlining directions for future research.

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Who is Tweeting? A Scoping Review of Methods to Establish Race and Ethnicity from Twitter Datasets (Preprint)

10.2196/preprints.35788 ◽

2021 ◽

Author(s):

Su Golder ◽

Robin Stevens ◽

Karen O'Conor ◽

Richard James ◽

Graciela Gonzalez-Hernandez

Keyword(s):

Social Media ◽

Scoping Review ◽

Race And Ethnicity ◽

Best Practice ◽

English Language ◽

Census Data ◽

Future Research ◽

Social Media Data ◽

Lower Accuracy ◽

Media Data

BACKGROUND Background: A growing amount of health research uses social media data. Those critical of social media research often cite that it may be unrepresentative of the population, but the suitability of social media data in digital epidemiology is more nuanced. Identifying the demographics of social media users can help establish representativeness. OBJECTIVE Objectives: We sought to identify the different approaches or combination of approaches to extract race or ethnicity from social media and report on the challenges of using these methods. METHODS Methods: We present a scoping review to identify the methods used to extract race or ethnicity from Twitter datasets. We searched 17 electronic databases and carried out reference checking and handsearching in order to identify relevant articles. Sifting of each record was undertaken independently by at least two researchers with any disagreement discussed. The included studies could be categorized by the methods the authors applied to extract race or ethnicity. RESULTS Results: From 1249 records we identified 67 that met our inclusion criteria. The majority focus on US based users and English language tweets. A range of types of data were used including Twitter profile -pictures or information from bios (such as names or self-declarations), or location and/or content in the tweets themselves. A range of methodologies were used including using manual inference, linkage to census data, commercial software, language/dialect recognition and machine learning. Not all studies evaluated their methods. Those that did found accuracy to vary from 45% to 93% with significantly lower accuracy identifying non-white race categories. The inference of race/ethnicity raises important ethical questions which can be exacerbated by the data and methods used. The comparative accuracy of different methods is also largely unknown. CONCLUSIONS Conclusion: There is no standard accepted approach or current guidelines for extracting or inferring race or ethnicity of Twitter users. Social media researchers must use careful interpretation of race or ethnicity and not over-promise what can be achieved, as even manual screening is a subjective, imperfect method. Future research should establish the accuracy of methods to inform evidence-based best practice guidelines for social media researchers, and be guided by concerns of equity and social justice.

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A Scoping Review of Medical Laboratory Science and Simulation: Promoting a Path Forward with Best Practices

Laboratory Medicine ◽

10.1093/labmed/lmab087 ◽

2021 ◽

Author(s):

Tera L Webb ◽

Jarkeshia McGahee ◽

Michelle R Brown

Keyword(s):

Scoping Review ◽

Best Practice ◽

Case Reports ◽

Empirical Studies ◽

Research Literature ◽

Medical Laboratory ◽

Future Research ◽

Healthcare Team ◽

Medical Laboratory Science ◽

Laboratory Science

Abstract Objective In medical laboratory science, there is a need to enhance the clinical learning curriculum beyond laboratory skill and diagnostic interpretation competency. Incorporating simulation presents an opportunity to train and produce medical laboratory scientists with the skills to communicate and work effectively in an interprofessional healthcare team. Methods A scoping review was performed to (i) understand the landscape of research literature on medical laboratory science and simulation and (ii) provide a path for future research directions. The International Nursing Association for Clinical Simulation and Learning Standards of Best Practice: Simulation were used as a guiding framework for literature that described simulation activities. Results Out of 439 articles from multiple databases, 32 were eligible for inclusion into this review. Of the 14 articles that described a simulation activity, only 3 described or partially described each component of the best practice criteria for simulation. Articles that did not describe the design and implementation of simulation (n = 18) consisted of 7 opinion-based papers, 4 narrative reviews, 5 case reports, and 2 empirical papers. Conclusion Despite increases in medical laboratory science with simulation, there is a need for more detailed empirical studies, more studies with an interprofessional context, and more methodological rigor.

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Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19

Advances in Simulation ◽

10.1186/s41077-020-00150-0 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Jean-Christophe Servotte ◽

T. Bram Welch-Horan ◽

Paul Mullan ◽

Justine Piazza ◽

Alexandre Ghuysen ◽

...

Keyword(s):

Emergency Department ◽

Best Practice ◽

Situational Awareness ◽

Future Research ◽

Organizational Impact ◽

Improve Performance ◽

Professional Background ◽

Best Practice Guidelines ◽

Clinical Events

Abstract Background Multiple guidelines recommend debriefing after clinical events in the emergency department (ED) to improve performance, but their implementation has been limited. We aimed to start a clinical debriefing program to identify opportunities to address teamwork and patient safety during the COVID-19 pandemic. Methods We reviewed existing literature on best-practice guidelines to answer key clinical debriefing program design questions. An end-of-shift huddle format for the debriefs allowed multiple cases of suspected or confirmed COVID-19 illness to be discussed in the same session, promoting situational awareness and team learning. A novel ED-based clinical debriefing tool was implemented and titled Debriefing In Situ COVID-19 to Encourage Reflection and Plus-Delta in Healthcare After Shifts End (DISCOVER-PHASE). A facilitator experienced in simulation debriefings would facilitate a short (10–25 min) discussion of the relevant cases by following a scripted series of stages for debriefing. Data on the number of debriefing opportunities, frequency of utilization of debriefing, debriefing location, and professional background of the facilitator were analyzed. Results During the study period, the ED treated 3386 suspected or confirmed COVID-19 cases, with 11 deaths and 77 ICU admissions. Of the 187 debriefing opportunities in the first 8-week period, 163 (87.2%) were performed. Of the 24 debriefings not performed, 21 (87.5%) of these were during the four first weeks (21/24; 87.5%). Clinical debriefings had a median duration of 10 min (IQR 7–13). They were mostly facilitated by a nurse (85.9%) and mainly performed remotely (89.8%). Conclusion Debriefing with DISCOVER-PHASE during the COVID-19 pandemic were performed often, were relatively brief, and were most often led remotely by a nurse facilitator. Future research should describe the clinical and organizational impact of this DISCOVER-PHASE.

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