scholarly journals A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice

2021 ◽  
Vol 18 (22) ◽  
pp. 11932
Author(s):  
Sean Paul Teeling ◽  
Carmel Davies ◽  
Marlize Barnard ◽  
Laserina O’Connor ◽  
Alice Coffey ◽  
...  
Keyword(s):  
Evidence Synthesis ◽  
Quality Care ◽  
Realist Review ◽  
Program Theory ◽  
Care Process ◽  
Midwifery Practice ◽  
Implementation Program ◽  
Process Metrics ◽  
Nurses And Midwives ◽  
Rapid Realist Review

Quality measurement initiatives promote quality improvement in healthcare but can be challenging to implement effectively. This paper presents a Rapid Realist Review (RRR) of published literature on Quality Care-Process Metrics (QCP-M) implementation in nursing and midwifery practice. An RRR informed by RAMESES II standards was conducted as an efficient means to synthesize evidence using an expert panel. The review involved research question development, quality appraisal, data extraction, and evidence synthesis. Six program theories summarised below identify the key characteristics that promote positive outcomes in QCP-M implementation. Program Theory 1: Focuses on the evidence base and accessibility of the QCP-M and their ease of use by nurses and midwives working in busy and complex care environments. Program Theory 2: Examines the influence of external factors on QCP-M implementation. Program Theory 3: Relates to existing cultures and systems within clinical sites. Program Theory 4: Relates to nurses’ and midwives’ knowledge and beliefs. Program Theory 5: Builds on the staff theme of Programme Theory four, extending the culture of organizational learning, and highlights the meaningful engagement of nurses and midwives in the implementation process as a key characteristic of success. Program Theory 6: Relates to patient needs. The results provide nursing and midwifery policymakers and professionals with evidence-based program theory that can be translated into action-orientated strategies to help guide successful QCP-M implementation.

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 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 Development of nursing quality care process metrics and indicators for intellectual disability services: a literature review and modified Delphi consensus study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Owen Doody ◽  
Fiona Murphy ◽  
Rosemary Lyons ◽  
Anne Gallen ◽  
Judy Ryan ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Quality Care ◽  
Consensus Meeting ◽  
Care Process ◽  
Disability Services ◽  
Nursing Process ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
Process Metrics ◽  
Nursing Quality

Abstract Background Nursing process quality care metrics and indicators are quantifiable measures of the nursing care delivered to clients. They can be used to identify and support nurses’ contribution to high quality, safe, client care and are lacking in specialist intellectual disability nursing. In a national Nursing Quality Care-Metrics project for Irish intellectual disability services, a set of nursing quality care process metrics and associated indicators were established for intellectual disability services. Methods A two-stage design approach was undertaken; a broad scoping review of the literature and a modified Delphi consensus process. The Delphi included a four round e-Delphi survey and a consensus meeting. Four hundred one intellectual disability nurses working in Ireland were recruited for the surveys and 20 stakeholders attended the consensus meeting. Results From the review, 20 existing and 16 potential intellectual disability nursing metrics were identified for nurses to prioritise in the e-surveys. After the four survey rounds, 12 intellectual disability nursing metrics and 84 associated indicators were identified. Following the consensus meeting, these were reduced to 12 metrics and 79 indicators. Conclusions This first set of intellectual disability nursing process metrics and associated indicators has been identified for implementation in practice. These metrics while developed in Ireland have international relevance and their application and appropriateness in practice needs to be evaluated.

scholarly journals Developing a program theory of patient engagement in patient-oriented research and the impacts on the health care system: protocol for a rapid realist review

CMAJ Open ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. E530-E534
Author(s):  
Elaine Zibrowski ◽  
Shelagh McDonald ◽  
Heather Thiessen ◽  
Ray VanDusen ◽  
Catherine Boden ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Patient Engagement ◽  
Realist Review ◽  
Program Theory ◽  
Rapid Realist Review ◽  
Oriented Research ◽  
Care System

scholarly journals Untangling the inter-relatedness within integrated care programmes for community-dwelling frail older people: a rapid realist review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043280
Author(s):  
Anam Ahmed ◽  
Maria E T C van den Muijsenbergh ◽  
Janne C Mewes ◽  
Walter P Wodchis ◽  
Hubertus J M Vrijhoef
Keyword(s):  
Older People ◽  
Integrated Care ◽  
Informal Caregivers ◽  
Realist Review ◽  
Community Dwelling ◽  
Care Process ◽  
Multidisciplinary Teams ◽  
Frail Older People ◽  
Programme Theory ◽  
Rapid Realist Review

ObjectiveTo identify the relationships between the context in which integrated care programmes (ICPs) for community-dwelling frail older people are applied, the mechanisms by which the programmes do (not) work and the outcomes resulting from this interaction by establishing a programme theory.DesignRapid realist review.Inclusion criteriaReviews and meta-analyses (January 2013–January 2019) and non-peer-reviewed literature (January 2013–December 2019) reporting on integrated care for community-dwelling frail older people (≥60 years).AnalysisSelection and appraisal of documents was based on relevance and rigour according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards criteria. Data on context, mechanisms, programme activities and outcomes were extracted. Factors were categorised into the five strategies of the WHO framework of integrated people-centred health services (IPCHS).Results27 papers were included. The following programme theory was developed: it is essential to establish multidisciplinary teams of competent healthcare providers (HCPs) providing person-centred care, closely working together and communicating effectively with other stakeholders. Older people and informal caregivers should be involved in the care process. Financial support, efficient use of information technology and organisational alignment are also essential. ICPs demonstrate positive effects on the functionality of older people, satisfaction of older people, informal caregivers and HCPs, and a delayed placement in a nursing home. Heterogeneous effects were found for hospital-related outcomes, quality of life, healthcare costs and use of healthcare services. The two most prevalent WHO-IPCHS strategies as part of ICPs are ‘creating an enabling environment’, followed by ‘strengthening governance and accountability’.ConclusionCurrently, most ICPs do not address all WHO-IPCHS strategies. In order to optimise ICPs for frail older people the interaction between context items, mechanisms, programme activities and the outcomes should be taken into account from different perspectives (system, organisation, service delivery, HCP and patient).

scholarly journals The development of Nursing Quality Care Process Metrics and Indicators for use in Older Persons Care Settings: A Delphi‐Consensus Study

2019 ◽  
Vol 75 (12) ◽  
pp. 3471-3484 ◽  
Author(s):  
Fiona Murphy ◽  
Owen Doody ◽  
Rosemary Lyons ◽  
Anne Gallen ◽  
Mary Nolan ◽  
...  
Keyword(s):  
Older Persons ◽  
Quality Care ◽  
Care Process ◽  
Delphi Consensus ◽  
Process Metrics ◽  
Nursing Quality

scholarly journals Supporting Healthy Aging through the Scale-Up, Spread, and Sustainability of Assistive Technology Implementation: A Rapid Realist Review of Participatory Co-Design for Assistive Technology with Older Adults

2021 ◽  
Vol 7 ◽  
pp. 233372142110232
Author(s):  
Simon Carroll ◽  
Karen Kobayashi ◽  
Matilde N. Cervantes ◽  
Shannon Freeman ◽  
Manik Saini ◽  
...  
Keyword(s):  
Older Adults ◽  
Assistive Technology ◽  
Healthy Aging ◽  
Scale Up ◽  
Realist Review ◽  
Two Dimensions ◽  
Assistive Technologies ◽  
Program Theory ◽  
Political Dimension ◽  
Rapid Realist Review

Objective: To identify the key mechanisms, contexts, and outcomes that drive the successful participatory co-design of assistive technologies. Method: A rapid realist review was conducted using a systematic search strategy. After screening, a final set of 28 articles were included. Articles were analyzed for evidence relevant to our initial program theory (IPT), and context-mechanism-outcome configurations were developed, resulting in a revised program theory. Results: All 28 articles included were highly relevant to the IPT, and had sufficient detail regarding the process of participatory co-design. The findings of this review highlight several key context-mechanism-outcome configurations as potential patterns in the data under the two dimensions of the evolving program theory: knowledge integration and the ethico-political dimension. Discussion: This review revealed the key mechanisms of mutual awareness, mutual learning, trust, and reciprocity that need to be taken into account in AT development and assessment. We concluded that participatory co-design requires a restructuring of power relations between end-users and those traditionally in control of technology design. These findings inform the development and assessment of AT for older adults and help guide policy/decision-makers to move forward with the now urgent agenda for scale-up and spread, initiated by the burning platform of the COVID-19 pandemic.

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.

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