Critical Analysis of the Evidence Safety in Nursing Home Settings

Project Summary Title and Description

Critical Analysis of the Evidence Safety in Nursing Home Settings
Resident safety issues are common in nursing homes. Relevant literature reports a range of poor clinical outcomes thought to be preventable if specific care processes were consistently implemented. The goal of this project was to summarize relevant literature, including identifying safety issues and contextual factors that affect safety in nursing homes; potential hospital safety interventions of relevance to nursing homes; literature on safety interventions evaluated in nursing homes; barriers and facilitators of interventions; and future directions for safety research in this setting.
Authors of Report
Methodology description
We had conversations with Key Informants representing multiple stakeholder groups. We conducted literature searches to identify recent systematic reviews of interventions addressing safety areas in nursing homes. We also searched the literature for newly published studies of interventions
Data has been retrospectively entered. Study characteristics and outcomes data have been imported to SRDR.
Funding Source

Key Questions

1. GQ 1: Describe the intervention for resident safety practices in nursing home settings GQ1a. What are the safety issues of particular concern in the nursing home setting? GQ1b. Are there important differences in safety issues for short-stay versus long-stay residents? GQ1c. Are there specific interventions that have improved patient safety in the hospital setting that could transfer to the nursing home setting, but have yet to be tested as such?
2. GQ 2: Describe the context in which the intervention is used for safety practices in nursing home settings GQ2a. What characteristics and qualities of nursing homes and nursing home residents create unique settings for assessing safety and may affect choice of intervention and success rates? Considerations include: a. Staffing – type, education, numbers, turnover b. For-profit versus not-for-profit c. Bed size d. Particular vulnerability of the residents e. Resident mix, including short and long stay
3. GQ 3: Describe the current evidence of the intervention for safety practices in nursing home settings GQ3a. What is the state of the current research based on the following criteria: a. Indication/resident inclusion criteria b. Type of intervention c. Study design/size d. Comparator e. Length of follow up g. Outcomes h. Sources of outcome data (i.e., facility self-report versus resident/family self-report versus objective, independent assessments)
4. GQ 4: Identify the important issues raised by the intervention for safety practices in nursing home settings GQ4a. What is the uptake of evidence-based nursing home interventions beyond individual test sites? What are the most important barriers/facilitators to uptake of successful interventions? GQ4b: What major areas for future research remain regarding resident safety in nursing homes? GQ4c: In what ways is the field of long-term care changing such that resident safety interventions may need to adapt to a new environment, and what additional challenges do these changing conditions bring to increasing long-term care resident safety?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

Characteristics and effectiveness of fall prevention programs in nursing homes: a systematic review and meta-analysis of randomized controlled trials.
Hip protectors for preventing hip fractures in older people.2014
Interventions for preventing falls in older people in care facilities and hospitals.2012
Interventions designed to prevent healthcare bed-related injuries in patients.2011
Exercise for falls and fracture prevention in long term care facilities: a systematic review and meta-analysis.
Falls prevention for the elderly.2012
Effectiveness of intervention programs in preventing falls: a systematic review of recent 10 years and meta-analysis.2012
Association Between Vitamin D Dosing Regimen and Fall Prevention in Long-term Care Seniors.2011
Effectiveness of multifaceted fall-prevention programs for the elderly in residential care.2008
Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses.2007
Repositioning for pressure ulcer prevention in adults.2014
Preventing in-facility pressure ulcers as a patient safety strategy: a systematic review.2013
Comprehensive programs for preventing pressure ulcers: a review of the literature.2012
Pressure ulcers.
Treatment of pressure ulcers: a systematic review.
Infection prevention in long-term care: a systematic review of randomized and nonrandomized trials.2013
Interventions for preventing delirium in older people in institutional long-term care.2014
Medication reviews for nursing home residents to reduce mortality and hospitalization: systematic review and meta-analysis.2014
Interventions to optimise prescribing for older people in care homes.2013
The effect of interventions to reduce potentially inappropriate antibiotic prescribing in long-term care facilities: a systematic review of randomised controlled trials.2013
Medication reconciliation during the transition to and from long-term care settings: a systematic review.-- Not Found --
Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials.2011
Computerised clinical decision support systems to improve medication safety in long-term care homes: a systematic review.2015
Antipsychotic use in nursing homes varies by psychiatric consultant.2014
Interventions to optimise prescribing in care homes: systematic review.2011
Interventions to improve transitional care between nursing homes and hospitals: a systematic review.2010

Downloadable Data Content

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