The experiences of family members in the nursing home to hospital transfer decision

Abrahamson, Kathleen; Bernard, Brittany; Magnabosco, Lara; Nazir, Arif; Unroe, Kathleen T.

doi:10.1186/s12877-016-0359-2

Cited by 28 publications

(59 citation statements)

References 19 publications

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“…Thirty-one studies considered stakeholder experiences in more detail. Stakeholders experienced various situations in urgent care: from hospitalisation decisions, 35 37 54 to withholding treatment at the end of life, 29 37 58 59 to prescribing antibiotics. 57 58 60 …”

Section: Resultsmentioning

confidence: 99%

“… 53 There were also barriers identified by professionals, with reports from care facility and emergency department staff of carers directly contradicting instructions in advance care plans, ordering more burdensome interventions. 35 59 69 Medical professionals were seen to take the lead in decision making in urgent care. 29 37 Involvement of informal carers was reported to lead to more aggressive treatment, for example, carer awareness of infection episodes for people with dementia in care homes lead to increased hospital transfers.…”

Section: Resultsmentioning

confidence: 99%

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Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

et al. 2020

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ObjectivesPeople with dementia are more vulnerable to complications in urgent health situations due to older age, increased comorbidity, higher dependency on others and cognitive impairment. This review explored the factors associated with urgent care use in dementia and the experiences of people with dementia, informal carers and professionals.DesignScoping review. The search strategy and data synthesis were informed by people with dementia and carers.Data sourcesSearches of CINAHL, Embase, Medline, PsycINFO, PubMed were conducted alongside handsearches of relevant journals and the grey literature through 15 January 2019.Eligibility criteriaEmpirical studies including all research designs, and other published literature exploring factors associated with urgent care use in prehospital and emergency room settings for people with dementia were included. Two authors independently screened studies for inclusion.Data extraction and synthesisData were extracted using charting techniques and findings were synthesised according to content and themes.ResultsOf 2967 records identified, 54 studies were included in the review. Specific factors that influenced use of urgent care included: (1) common age-related conditions occurring alongside dementia, (2) dementia as a diagnosis increasing or decreasing urgent care use, (3) informal and professional carers, (4) patient characteristics such as older age or behavioural symptoms and (5) the presence or absence of community support services. Included studies reported three crucial components of urgent care situations: (1) knowledge of the patient and dementia as a condition, (2) inadequate non-emergency health and social care support and (3) informal carer education and stress.ConclusionsThe scoping review highlighted a wider variety of sometimes competing factors that were associated with urgent care situations. Improved and increased community support for non-urgent situations, such as integrated care, caregiver education and dementia specialists, will both mitigate avoidable urgent care use and improve the experience of those in crisis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

et al. 2020

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“…None of the articles describe utilising evidence to help residents or their families decide on treatment options. Two studies found a lack of provision of information to residents and their families, and reported that staff rarely discussed the risks and benefits of treatment options [28] [38]. Some families indicated that there was a lack of information provided to them to assist in decision making [33].…”

Section: Evidenced-based Practicementioning

confidence: 99%

“…Education in SDM was recommended in two studies, [28] [38] particularly about the importance of family involvement. The articles analysed which utilised an educational intervention were predominantly quantitative approaches [40] [43]…”

Section: Educationmentioning

confidence: 99%

“…Barriers to execution of wishes include a lack of documented resident preferences [33], or inadequate planning and communication [29]. Systematic operationalization of an intervention requires regular and ongoing education of all stakeholders [44] as well as auditing of existing processes, policies and strategic planning about organisational changes that may be required for success [28] [37]. High staff turn-over and changes to management of RAC is a threat to sustainability of interventions [44].…”

Section: Documentation Communication and Enactmentmentioning

confidence: 99%

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Shared Decision Making in Residential Aged Care: A Framework Synthesis

Ervin¹,

Blackberry²,

Haines³

2017

OJN

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Very little is known about shared decision making (SDM) in residential aged care, despite world-wide policy and imperatives that encourage resident choice and autonomy. This paper provides a framework synthesis of SDM in residential aged care (RAC) and potential barriers and enablers to implement SDM utilising a theoretical framework of implementation. A review of the literature on SDM in RAC from 2005 to 2016 was undertaken, using MEDLINE (Ovid), CINAHL, PsychINFO and Scopus. The articles were synthesised by utilising an implementation theory framework to better understand what may facilitate or hinder the introduction of SDM. Eighteen studies were identified and analysed to determine barriers and enablers to SDM in RAC from the perspectives of staff, residents and relatives. A workplace culture of person-centred care and judicious use of research evidence are enablers of SDM. There is a potential need for additional resources, such as education for staff and families to enable implementation of SDM. Implementation of any health care intervention, including SDM, relies on many complex factors but these are predominantly related to capacity. Determining current uptake and readiness of RAC organisations, residents and their families to adopt SDM is an essential starting point.

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Notfallsituationen und Krankenhauszuweisungen in Pflegeeinrichtungen – ein Scoping-Review zu Begleitumständen und versorgungsrelevanten Maßnahmen

Bretschneider

Poeck

Freytag

et al. 2022

Bundesgesundheitsbl

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Zusammenfassung Hintergrund Pflegeheimbewohner:innen werden häufiger hospitalisiert als nicht institutionalisierte Gleichaltrige. Eine Vielzahl an Rettungsdiensteinsätzen und Krankenhauszuweisungen wird als potenziell vermeidbar eingeordnet. Ziele der Arbeit Zuweisungsbegünstigende Begleitumstände bei Notfallsituationen in Pflegeeinrichtungen sowie Ansätze zur Reduktion von Krankenhauszuweisungen sollen identifiziert werden, um die Komplexität der Versorgungsprozesse und Handlungsperspektiven aufzuzeigen. Material und Methoden Scoping-Review mit Analyse aktueller Original- und Übersichtsarbeiten (2015–2020) in den Datenbanken PubMed, CINAHL sowie per Handsuche. Ergebnisse Aus 2486 identifizierten Studien wurden 302 Studien eingeschlossen. Verletzungen, Frakturen, kardiovaskuläre und respiratorische Erkrankungen sowie Infektionskrankheiten sind die häufigsten retrospektiv erfassten Diagnosegruppen. Hinsichtlich der einweisungsbegünstigenden Umstände konnten verschiedene Aspekte identifiziert werden: bewohnerbezogene (z. B. Multimorbidität, fehlende Patientenverfügungen), einrichtungsbezogene (u. a. Personalfluktuation, Unsicherheiten), arztbezogene (z. B. mangelnde Erreichbarkeit, erschwerter Zugang zu Fachärzt:innen) und systembedingte (z. B. eingeschränkte Möglichkeiten zur Diagnostik und Behandlung in Einrichtungen). Verschiedene Ansätze zur Verminderung von Krankenhauszuweisungen sind in Erprobung. Diskussion Vielfältige Begleitumstände beeinflussen das Vorgehen in Notfallsituationen in Pflegeeinrichtungen. Interventionen zur Reduktion von Krankenhauszuweisungen adressieren daher u. a. die Stärkung der Kompetenz des Pflegepersonals, die interprofessionelle Kommunikation und systemische Ansätze. Ein umfassendes Verständnis der komplexen Versorgungsprozesse ist die wesentliche Grundlage für die Entwicklung und Implementierung effektiver Interventionen.

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The experiences of family members in the nursing home to hospital transfer decision

Cited by 28 publications

References 19 publications

Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

Urgent care for patients with dementia: a scoping review of associated factors and stakeholder experiences

Shared Decision Making in Residential Aged Care: A Framework Synthesis

Notfallsituationen und Krankenhauszuweisungen in Pflegeeinrichtungen – ein Scoping-Review zu Begleitumständen und versorgungsrelevanten Maßnahmen

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