Nursing
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24
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Item Designing clinical indicators for common residential aged care conditions and processes of care: The CareTrack Aged development and validation study(2022-04-21) Hibbert, Peter D.; Molloy, Charlotte J.; Wiles, Louise K.; Cameron, Ian D.; Gray, Leonard C.; Reed, Richard L..; Kitson, Alison; Georgiou, Andrew; Gordon, Susan J.; Westbrook, Johanna; Arnolda, Gaston; Mitchell, Rebecca J.; Rapport, Frances; Estabrooks, Carole; Alexander, Gregory L.; Vincent, Charles; Edwards, Adrian; Carson-Stevens, Andrew; Wagner, Cordula; McCormack, Brendan; Braithwaite, JeffreyPeople who live in aged care homes have high rates of illness and frailty. Providing evidence-based care to this population is vital to ensure the highest possible quality of life. This study (CareTrack Aged, CT Aged) aimed to develop a comprehensive set of clinical indicators for guideline-adherent, appropriate care of commonly managed conditions and processes of care in aged care. Indicators were formulated from recommendations found through systematic searches of Australian and international clinical practice guidelines (CPGs). Experts reviewed the indicators using a multi-round modified Delphi process to develop consensus on what constitutes appropriate care. From 139 CPGs, 5,609 recommendations were used to draft 630 indicators. Clinical experts (n=41) reviewed the indicators over two rounds. A final set of 236 indicators resulted, mapped to 16 conditions and processes of care. The conditions and processes were admission assessment; bladder and bowel problems; cognitive impairment; depression; dysphagia and aspiration; end of life/palliative care; hearing and vision; infection; medication; mobility and falls; nutrition and hydration; oral and dental care; pain; restraint use; skin integrity; and sleep. The suite of CT Aged clinical indicators can be used for research, assessment of quality of care in individual facilities and across organisations to guide improvement, and to supplement regulation or accreditation of the aged care sector. They are a step forward for Australian and international aged care sectors, helping to improve transparency, so that the level of care delivered to aged care consumers can be rigorously monitored and continuously improved.Item FIRE (Facilitating Implementation of Research Evidence): a study protocol(Biomed Central, 2012-03) Seers, Kate; Cox, Karen; Crichton, Nicola J.; Edwards, Rhiannon Tudor; Eldh, Ann Catrine; Estabrooks, Carole A.; Harvey, Gill; Hawkes, Claire; Kitson, Alison; Linck, Pat; McCarthy, Geraldine; McCormack, Brendan; Mockford, Carole; Rycroft-Malone, Jo; Titchen, Andy; Wallin, LarsBackground Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids. Objectives This study aims to advance understanding about the contribution facilitation can make to implementing research findings into practice via: extending current knowledge of facilitation as a process for translating research evidence into practice; evaluating the feasibility, effectiveness, and cost-effectiveness of two different models of facilitation in promoting the uptake of research evidence on continence management; assessing the impact of contextual factors on the processes and outcomes of implementation; and implementing a pro-active knowledge transfer and dissemination strategy to diffuse study findings to a wide policy and practice community. Setting and sample Four European countries, each with six long-term nursing care sites (total 24 sites) for people aged 60 years and over with documented urinary incontinence Methods and design Pragmatic randomised controlled trial with three arms (standard dissemination and two different programmes of facilitation), with embedded process and economic evaluation. The primary outcome is compliance with the continence recommendations. Secondary outcomes include proportion of residents with incontinence, incidence of incontinence-related dermatitis, urinary tract infections, and quality of life. Outcomes are assessed at baseline, then at 6, 12, 18, and 24 months after the start of the facilitation interventions. Detailed contextual and process data are collected throughout, using interviews with staff, residents and next of kin, observations, assessment of context using the Alberta Context Tool, and documentary evidence. A realistic evaluation framework is used to develop explanatory theory about what works for whom in what circumstances. Trial registration Current Controlled Trials ISRCTN11598502.