Quality of care in long-term care institutions: A scoping review of literature

Abstract

This review sought to answer the question “What theoretical models have been used to define and evaluate the quality of care provided to older adults in long-term care institutions?” The employed study methodology followed the recommendations of the Joanna Briggs Institute Reviewers Manual. Using MESH terms and keywords such as “elderly,” “long-term care,” and “theoretical,” four electronic databases (i.e., PubMed, Scopus, Web of Science, and LILACS) were searched for articles in Portuguese, English, and Spanish, without a time frame restriction. Titles and abstracts were independently screened by two reviewers, followed by a full-text review. A total of 1,211 articles met our inclusion criteria, 80 were selected for full reading, and 21 were included for qualitative synthesis. The theoretical models cited in the studies included the multidimensional model (n = 10); the structure, process, and results model (n = 8); a theory centered on the person (n = 2); and one centered on the work environment (n = 1). Few articles used a conceptual model as the basis for assessing long-term care institutions, which is important for the construction of instruments and indicators that assess the quality of care.

Development and content validation for a self-assessment instrument of care quality in long-term care facilities for older adults

“…It pertains to the team of professionals involved in providing care to older adults residing in ILPIs. It is essential to consider the technical requirements for each professional category, ensure the minimum number of professionals, establish ongoing education, and enhance the work process to ensure professional satisfaction and, consequently, better meet the needs of the residents 10,14,15 .…”

“…Nonetheless, it is essential to maintain involvement with family and the community, promoting autonomy and quality of life. This interaction helps to preserve mental health, satisfaction, and independence 10,17 .…”

“…The management of the ILPI encompasses administrative processes aimed at achieving outcomes, ensuring a better quality of life for older adults, based on regulations that must be followed and established by legislation 10,18 .…”

“…The health surveillance conducts external evaluation processes with the objective of inspection, in accordance with established norms. However, systematic internal evaluation processes that facilitate the identification of issues, planning, and decisionmaking by those involved in the daily care of older adults have not been identified 9,10 .…”

“…One of the many existing tools for evaluation, called "Observable Indicators of Nurse Home Care Quality", utilizes the Integrated Multidimensional Model of Quality and Person-Centered Care and contains seven quality dimensions 10 . However, for the most part, these tools either do not employ a conceptual model, are not specifically designed for ILPIs, or do not incorporate the perceptions of older adults, staff, managers, and family members in a comprehensive assessment 10 .…”