Wounds and skin conditions are common in residential aged care settings and can result in significant physical, psychosocial and economic impacts on residents and care systems. Ensuring high-quality evidence-based wound and skin care in residential aged care facilities is essential to promote resident well-being. However, the integration of such practices is a complex knowledge translation endeavour, influenced by contextual challenges. A comprehensive, systematic and theory-based framework can be used to guide the complex process. The aim of this study was to develop and validate a framework for wound care knowledge translation in residential aged care facilities.
A multi-method, three-phase design was used. Phase 1 involved two systematic reviews to identify elements from theoretical and empirical perspectives, resulting in a draft framework. Phase 2 consisted of an online participatory design workshop with 10 key stakeholders to contextualise the elements identified in Phase 1. In Phase 3, a two-round modified e-Delphi process was conducted with 11 international experts to refine and validate the framework.
The developed framework, which recognises knowledge translation as a process, comprises four vertical phases: pre-implementation, implementation, evaluation and sustainment. Additionally, it includes four horizontal components: Process steps, Adoption process, Values as a moral compass and Engagement for individual behaviour change and team development. Consensus was reached on the ‘PAVE’ framework's comprehensiveness, relevance, usability and value for guiding knowledge translation in residential aged care facilities.
The PAVE framework offers a tool for implementation scientists, gerontology nurses and researchers to plan and guide knowledge translation for establishing evidence-based wound and skin care practices in residential aged care facilities, improving the quality and safety of care to older people. The framework holds potential for broader application across various interventions and healthcare settings. Future studies should explore the PAVE framework's effectiveness in diverse healthcare settings.
Although educators are working to improve gerontological content in baccalaureate nursing programmes to keep pace with changing population demographics, it is unclear what types of educational interventions are occurring.
The aim of this scoping review was to map baccalaureate nursing educational interventions related to ageing and the care of older people.
A search was conducted in six databases. Databases searched were CINAHL, Medline, EMBASE, Education Resources Information Centre (ERIC), Scopus, Education Database and Education Research Complete for articles published between January 2013 and June 2023. Sixty-five articles met all inclusion criteria. Data were extracted on year, country, characteristics of interventions, methodological approach, evaluation, analysis and outcomes. The Mixed Methods Appraisal Tool was used to assess quality. Analysis included descriptive frequencies and directed content analysis.
We examined the patterns of publication, research methodologies, quality, education types and types of outcomes used. We noted an increase in research in the past 10 years examining gerontological education and an increase in the use of simulation, e-learning and community clinical placements. Most studies were descriptive, with only four randomised controlled trials.
This review found improvement in the overall quality of reporting. Studies examining knowledge and skill have increased. There is heterogeneity in tools used to evaluate quantitative outcomes, and an increase in e-learning, simulation and clinical placements in community settings.
Stronger measures are warranted to ensure gerontological education is included throughout nursing education programmes. Education innovations must be spread to improve preparation of nursing graduates.
This research project explored nurse-led health goal setting activities in residents living in low-income and other residential senior housing communities.
As part of home visit clinical experiences, student nurses met with residents 3+ times to establish health goals, discuss goal progress and identify goal types, goal-achieving rewards and barriers/facilitators to goal attainment.
Themes emerged from identified goals: Getting Around, Maintaining and Regaining Health, Living as an Independent Adult and Relationships and Purpose. Rewards for achieving goals yielded themes: Feel Better About Myself; Sense of Accomplishment; I am in Control and Remain Independent. Barriers and facilitators to meeting goals were identified.
Findings from this study support prior findings of concerns facing older adults as identified by the Age Friendly Health Systems initiative, co-developed by The John A. Hartford Foundation, the Institute for Healthcare Improvement (IHI), the American Hospital Association (AHA) and the Catholic Health Association of the United States (CHA).
For decades, healthcare systems have enacted cost containment, which has led to nurses working within increasingly thinly resourced healthcare services influenced by political ideologies and often just trying to get through their shift. They may not have enough energy, support or background knowledge about what is behind the challenges they face or how they could effectively advocate for older people.
In this discussion paper, we provide an overview of three underlying political ideologies; discuss how these ideologies influence health and social care among western countries, examine how workplaces influenced by political ideology (e.g., resource allocation) can perpetuate ageism in healthcare decisions; explore advocacy and activism in nursing and suggest opportunities for nurses to disrupt negative practices.
We found common challenges among countries with the three ideologies—increasing older people, the need to spend money efficiently and older people's desire to age-in-place. Thus, there is critical importance of health and social community supports and informal caregivers. Although not perfect, a social democratic ideology appears to be more likely than the other ideologies to work towards valuing people of all ages, with greater potential for equitable access and to support people throughout their lifespan.
Nurses have an important role to play in suggesting improvements in health and social care. Nurses that work together through professional gerontological associations could be proactive in informing the public that their current political ideology could be perpetuating ageism in health and social care systems.
Nurses need to educate themselves about the political ideology in their country and critically examine how it influences the health and social care of older people. Also necessary that nurses take an advocacy/activist role for older people’s health and social care needs.
This systematic review and meta-analysis augments the existing body of evidence concerning the effect of oral health education or caregiver training on the oral hygiene status of institutionalised older adults.
The study follows a protocol registered in PROSPERO (CRD42022309962). We systematically searched four electronic databases, complemented by manual literature searches. We screened eligible studies and extracted data utilising a meticulously designed form. The quality of the studies has been appraised using RoB 2 and RoB 2 CRT. For quantitative analysis, RevMan 5.4.1 has been employed.
We screened 4962 records and evaluated 31 full texts. We conducted qualitative synthesis on 14 trials and subjected data from four trials to quantitative analysis. We assessed the effectiveness of training caregivers regarding the oral health of older adults on denture hygiene status using the post-intervention denture hygiene index scores (mean ± SD). Sub-group analysis, considering the cognitive ability of the study population, revealed a significant difference favouring the intervention compared to no intervention: SMD −0.59; 95% CI (−0.88 to −0.31). Similarly, the oral health education of caregivers was noted to have a statistically significant improvement in the dental plaque scores: SMD −0.51; 95% CI (−0.76 to −0.26). Three studies showed a ‘high risk of bias’, and five studies showed ‘some concerns’.
Oral health education programmes on caregiver training by health care/para-health care professionals significantly improve the oral hygiene status of institutionalised older adults. More robust clinical trials are needed to substantiate the evidence on the effectiveness of educating caregivers about the oral health of older adults.
The Advance Care Planning (ACP) Engagement Survey, initially developed in English, was designed to assess behaviour related to the ACP process. Although ACP is widely recognised globally, its adoption and practice differ considerably among countries, primarily due to unique cultural and policy-related factors. Therefore, ensuring appropriate translation and cultural validation of the tool is critical for its effective use in varied contexts. This study aimed to translate and culturally adapt the ACP Engagement Survey for use with Korean older people and to examine its psychometric properties.
This study used a cross-sectional survey design that was implemented in two phases. In phase 1, the ACP Engagement Survey underwent translation and cross-cultural adaptation from English to Korean by: (1) forward and backward translation, (2) committee review and (3) pretesting. In phase 2, psychometric properties of the finalised Korean version were examined via factor analysis, assessment of construct validity and analysis of internal consistency. The study sample comprised 235 community-dwelling older people with a mean age of 71.1 years.
The final Korean version of the ACP Engagement Survey (K-ACP-ES 12) was composed of 12 items across three factors: readiness, contemplation and self-efficacy. Hypothesis testing demonstrated construct validity of the K-ACP-ES 12 by a statistically significant correlation with the AD Knowledge Scale (r = 0.26, p < 0.001). In addition, the Korean version showed acceptable reliability, with a Cronbach's alpha of 0.93.
The K-ACP-ES 12 demonstrated good reliability, acceptable structural validity and supported hypothesis-testing construct validity. Evaluating a patient's engagement in ACP is essential for assessing ACP quality, which constitutes a principal outcome of the ACP process. The findings highlight the necessity of tailoring and validating measurement tools within specific cultural and policy contexts to ensure accurate assessment of ACP outcomes and enhance the instrument's utility across varied populations.
The findings underscore the importance of tailoring and validating measurement tools within specific cultural and policy contexts to ensure accurate ass
The prevalence of falls in Ontario-based long-term care homes is above the provincial benchmark. There is limited research exploring the reason for such a variation. The research question guiding this study was: What are the risk factors for falls among all residents in Ontario's LTC homes?
A retrospective, population-based study was conducted using Minimum Data Set assessments for all residents of long-term care in Ontario between April 2019 and March 2020. Binomial logistic regression analysis was used to determine the significance of the relationship of selected variables to falls.
Findings identified a significant relationship between several variables that were not previously found in the existing literature and falls.
This study has important implications for clinicians and researchers globally as they aim to better understand the increased prevalence of falls in older adults living in residential care.
Clinicians are encouraged to consider alternatives to high-risk medications and closely monitor residents on these medications, implement harm reduction strategies for residents with responsive behaviors, and routinely assess residents for bowel incontinence, cognitive decline, or increased care needs.
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