{"title":"社区实践在住宅老年护理:快速回顾","authors":"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","doi":"10.1111/opn.12563","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Nineteen articles reported on 13 residential aged care CoPs. Most CoPs aimed to improve care quality (<i>n</i> = 9, 69%) while others aimed to educate members (<i>n</i> = 3, 23%). Membership was often multidisciplinary (<i>n</i> = 8, 62%), and interactions were in-person (<i>n</i> = 6, 46%), online (<i>n</i> = 3, 23%) or both (<i>n</i> = 4, 31%). Some CoPs were developed with the aid of a planning group (<i>n</i> = 4, 31%) or as part of a larger collaborative (<i>n</i> = 4, 31%), and were maintained using a facilitator (n = 7, 54%) or adapted to member feedback (<i>n</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":48651,"journal":{"name":"International Journal of Older People Nursing","volume":"18 5","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.12563","citationCount":"0","resultStr":"{\"title\":\"Communities of practice in residential aged care: A rapid review\",\"authors\":\"Martin Read BBMed, Sanne Peters BEd, MEd, PostGradDipT, PhD, Noleen Bennett RN, MPH, PhD, Jill J. 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CoPs have been used in healthcare to improve clinical practice; however, little is known about their application to the unique residential aged care context.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Nineteen articles reported on 13 residential aged care CoPs. Most CoPs aimed to improve care quality (<i>n</i> = 9, 69%) while others aimed to educate members (<i>n</i> = 3, 23%). Membership was often multidisciplinary (<i>n</i> = 8, 62%), and interactions were in-person (<i>n</i> = 6, 46%), online (<i>n</i> = 3, 23%) or both (<i>n</i> = 4, 31%). Some CoPs were developed with the aid of a planning group (<i>n</i> = 4, 31%) or as part of a larger collaborative (<i>n</i> = 4, 31%), and were maintained using a facilitator (n = 7, 54%) or adapted to member feedback (<i>n</i> = 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":48651,\"journal\":{\"name\":\"International Journal of Older People Nursing\",\"volume\":\"18 5\",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-08-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/opn.12563\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Older People Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/opn.12563\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Older People Nursing","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/opn.12563","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Communities of practice in residential aged care: A rapid review
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.
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.
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