Figuring it Out in the Moment: A Theory of Unregulated Care Providers' Knowledge Utilization in Dementia Care Settings

Abstract

As a middle-range theory, Figuring it Out in the Moment is concrete and pragmatic information for promoting evidence-based dementia care not included in existing overarching knowledge utilization frameworks. Areas for further investigation include how knowledge utilization is conceptualized, as well as the influences of practitioners' clinical decision-making, the nature of caregiving with particular client populations, and the characteristics of individuals alone and in relationship on the utilization of best practice knowledge.

The Influence of Organizational Context on Best Practice Use by Care Aides in Residential Long-Term Care Settings

“…We located only 1 (qualitative) report of a study that examined best practice use in care aides. 4 This report described challenges for care aides in using best practice that included a context of uncertainty resulting from the complexities and unanticipated features of dementia care work, lack of recognition and struggles with being valued members of the team, and high needs for constructive peer relationships. We located no studies that considered the effects of individual and organizational factors on care aides' use of best practices in nursing homes settings.…”

“…6 They have significant needs for better care at end of life 7 and for consideration of what constitutes quality of care and quality of life at the end of their lives. In Canada 80% of direct "point of care" services to nursing home residents is provided by a group of unregulated workers 4 with various titles including personal support workers, care aides, and nursing assistants. Few reports even describe the characteristics of these frontline members of the care team, but care aides are essential elements of any efforts to improve quality of care and quality of life in nursing homes.…”

A Landscape for Training in Dementia Knowledge Translation (DKT)

“…Although all these numbers continue to rise, researchers, clinicians, and advocacy groups alike have identified a disconnection between new knowledge about dementia and the implementation of that knowledge for the benefit of patients (Alzheimer Society of Canada, 2010a; Janes, Sidani, Cott, & Rappolt, 2008;Rockwood, 2008). This is consistent with the observation of Graham and Tetroe (2007) who noted that the translation of research findings into clinical practice is often a slow and ambiguous process that spans multiple years and has variable results.…”

Optimizing the mobility of residents with dementia: a pilot study promoting healthcare aide uptake of a simple mobility innovation in diverse nursing home settings

“…Although healthcare aides provide most of the direct care for residents in long-term care settings, few strategies intended to facilitate the implementation of evidence into practice have been developed with healthcare aides in mind [23]. Even less research has been conducted on the effect of knowledge translation interventions on innovation uptake in long-term care settings where healthcare aides work.…”