Communities of practice in residential aged care: A rapid review

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY International Journal of Older People Nursing Pub Date : 2023-08-10 DOI:10.1111/opn.12563

Martin Read BBMed, Sanne Peters BEd, MEd, PostGradDipT, PhD, Noleen Bennett RN, MPH, PhD, Jill J. Francis BA, BMus, GDACP, PhD, Deirdre Fetherstonhaugh RN, MA, PhD, Wen Kwang Lim MBBS, FRACP, MD, Joanne Tropea BPhty, MPH, PhD

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Abstract

Background

Communities of practice (CoPs) have the potential to help address the residential aged care system's need for continuing education and quality improvement. CoPs have been used in healthcare to improve clinical practice; however, little is known about their application to the unique residential aged care context.

Objectives

This rapid review of CoPs for residential aged care was conducted to summarise the features of CoPs, how they are developed and maintained, and assess their effectiveness.

Methods

MEDLINE and CINAHL databases were searched for studies published from January 1991 to November 2022 about CoPs in residential aged care. Data were extracted regarding the CoPs' three key features of ‘domain’, ‘community’ and ‘practice’ as described by Wenger and colleagues. Kirkpatrick's four levels of evaluation (members' reactions, learning, behaviour and results) was used to examine studies on the effectiveness of CoPs. The Mixed Methods Appraisal Tool was used for quality appraisal.

Results

Nineteen articles reported on 13 residential aged care CoPs. Most CoPs aimed to improve care quality (n = 9, 69%) while others aimed to educate members (n = 3, 23%). Membership was often multidisciplinary (n = 8, 62%), and interactions were in-person (n = 6, 46%), online (n = 3, 23%) or both (n = 4, 31%). Some CoPs were developed with the aid of a planning group (n = 4, 31%) or as part of a larger collaborative (n = 4, 31%), and were maintained using a facilitator (n = 7, 54%) or adapted to member feedback (n = 2, 15%). Thirteen (81%) studies evaluated members' reactions, and three (24%) studies assessed members' behaviour. The heterogeneity of studies and levels of reporting made it difficult to synthesise findings.

Conclusions

This review revealed the variation in why, and how, CoPs have been used in residential aged care, which is consistent with previous reviews of CoPs in healthcare. While these findings can inform the development of CoPs in this context, further research is needed to understand how CoPs, including the membership makeup, delivery mode, facilitator type and frequency of meetings, impact quality of care.

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社区实践在住宅老年护理:快速回顾

实践社区(cop)有潜力帮助解决住宅老年护理系统对继续教育和质量改进的需求。cop已用于医疗保健，以改善临床实践;然而，它们在独特的住宅养老环境中的应用却鲜为人知。目的:本文对住宅养老服务的cop进行了快速回顾，总结了cop的特点，它们是如何发展和维护的，并评估了它们的有效性。方法检索1991年1月~ 2022年11月MEDLINE和CINAHL数据库中发表的有关住院老年护理中cop的研究。我们提取了温格及其同事所描述的cop的“领域”、“社区”和“实践”三个关键特征的数据。柯克帕特里克的四个评价水平(成员的反应、学习、行为和结果)被用来检验cop有效性的研究。采用混合方法评价工具进行质量评价。结果共报道13篇住宅养老机构cop，共19篇。大多数cop旨在提高护理质量(n = 9,69%)，而其他cop旨在教育成员(n = 3,23%)。成员通常是多学科的(n = 8, 62%)，互动是面对面的(n = 6, 46%)，在线的(n = 3, 23%)或两者兼而有之(n = 4, 31%)。一些cop是在计划小组的帮助下(n = 4,31%)或作为更大协作的一部分(n = 4,31%)开发的，并使用促进者(n = 7,54%)或根据成员反馈进行调整(n = 2,15%)。13项(81%)研究评估了成员的反应，3项(24%)研究评估了成员的行为。研究和报告水平的异质性使得很难综合研究结果。结论:本综述揭示了cop在住宅老年护理中使用的原因和方式的差异，这与之前关于cop在医疗保健中的应用的综述一致。虽然这些发现可以为在这种背景下cop的发展提供信息，但需要进一步研究以了解cop(包括成员组成、交付模式、主持人类型和会议频率)如何影响护理质量。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

期刊介绍： International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.