Challenges of conducting research in long-term care facilities: a systematic review

Lam, Helen R.; Chow, Selina; Taylor, Kate; Chow, Ronald; Lam, Henry; Bonin, Katija; Rowbottom, Leigha; Herrmann, Nathan

doi:10.1186/s12877-018-0934-9

Cited by 88 publications

(89 citation statements)

References 74 publications

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“…Only a minority of the 10,933 of relevant care homes across England were able to be approached. However, although staff from only 74 homes took part, to our knowledge, the 400 respondents is a high response rate for this population in the time available for recruitment (25). Eight further paper copies were also returned but these were incomplete and were not included within the data analysis.…”

Section: Resultsmentioning

confidence: 99%

Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff

Andrusjak

Barbosa

Mountain

2020

Preprint

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Background:Hearing and vision loss in older people has been proven to affect physical and mental health and increase the speed of cognitive decline. Studies have demonstrated that certain practices and improved staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which practices are being implemented in care homes. This study aimed to identify the gaps in staff knowledge regarding hearing and vision difficulties in older residents, and which practices known to improve ear and eye care in older care home residents are not commonly implemented in care homes in England.Methods:This study used a cross-sectional survey design. Survey questions were informed by the existing literature and were focused on practices, staff knowledge, and other aspects that have shown to affect residents’ hearing and vision care. The survey was sent to care homes across England between November 2018 and February 2019 via email and in paper format for care home staff to complete. Descriptive statistics and Chi-Square analysis were applied to identify the factors influencing the care being provided to care home residents. Results:A total of 400 care home staff responded from 74 care homes. The results revealed that screening tools are rarely used by staff to identify hearing and vision impairments; that care homes have limited access to other assistive devices for hearing and vision loss, and that audiology services do not regularly assess care home residents. A majority of staff who responded were not confident in ear and eye care. Responses were found to be influenced by the respondents’ job role, length of time working in care homes and also the care home type and care home size. Findings confirmed a lack of standardised practice and the importance of shared communication for promulgation of best practice.Conclusion:This study has identified that some practices known to facilitate ear and eye care are not commonly applied in a sample of English care homes. It has also shown that care home staff knowledge of ear and eye care is inconsistent. The information derived from this survey can be used to inform guidelines for best practice and inform needs for future research.

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Section: Resultsmentioning

confidence: 99%

Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff

Andrusjak

Barbosa

Mountain

2020

Preprint

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“…The challenges identified in research mirrored those outlined by Lam and colleagues. In their meta-analysis regarding research in LTCF, they identified eight themes that included facility/owner/ administrator factors, resident factors, staff caregiver factors, family caregiver factors, investigator factors, ethical/legal factors, methodological factors and budgetary factors [5]. Our work provided additional depth to their findings by providing a specific context for LTCF research.…”

Section: Discussionmentioning

confidence: 96%

Implementing a Clinical Research Program in Long Term Care Facilities: Experiences from the University of Louisville Center Excellence for Research in Infectious Diseases [CERID]

2019

RGH

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Background: According to the US Census Bureau International Report, in 2015, almost nine percent of the world's population was aged 65 and over. As the worldwide population ages, there is a need to understand how to best care for those individuals. Developing clinical research programs focusing on long term care (LTC) will be critical to defining best practice. Objectives: The objectives of this manuscript are to: 1) outline the challenges identified in performing clinical research in long term care facilities (LTCF), and 2) offer solutions for future clinical research in the LTC environment based upon our experiences. Methods: A research feasibility study was performed in 14 LTCFs in Louisville, Kentucky during 2018. Research questions involving identification of LTCF residents experiencing diarrhea were used as the basis for determining challenges and abilities to perform research in the LTC environment. Results: Challenges to performing clinical research involving an infectious disease were gathered throughout the twenty-week feasibility assessment period and organized into eight distinct yet interrelated areas. These included: 1) facility recruitment; 2) engagement of facility leadership; 3) engagement of facility personnel; 4) identification of research candidates; 5) consenting processes; 6) management of clinical samples; 7) navigating the medical record systems; and 8) study team workflow. Conclusions: This feasibility assessment found that conducting research in LTCFs was very different in almost every aspect from research conducted in the hospital setting. Results from this feasibility assessment will be used as a basis to determine a more comprehensive population-based incidence of C. difficile infection through the City of Louisville Diarrhea (CLOUD) study.

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“…Despite concordance being strongest in RACFs, many RACF residents who stated they had not completed ACP documentation actually did have documentation present in their file. Considering most residents in aged care have some degree of cognitive impairment, 43,44 it is possible that some a Self-report frequencies may differ from those reported in Tables 2 and 3 because participants may have had more than one type of ACP document.…”

Section: Discussionmentioning

confidence: 99%

Concordance Between Self-Reported Completion of Advance Care Planning Documentation and Availability of Documentation in Australian Health and Residential Aged Care Services

Buck

Detering

Pollard

et al. 2019

Journal of Pain and Symptom Management

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Context. Advance care planning (ACP) documentation needs to be available at the point of care to guide and inform medical treatment decision-making.Objective. To examine concordance between self-reported completion of ACP documentation and self-reported storage of the documentation at the person's current point of care with the availability of the documentation in that person's health record.Methods. A national multicenter audit of health records and a self-report survey of eligible audit participants in 51 Australian health and residential aged care services. The audit assessed availability of ACP documentation in the health record, whereas the survey assessed self-reported completion and storage of the ACP documentation at the person's current place of care. To ascertain concordance, survey and audit data were cross-tabulated and concordance rates and kappa statistics were calculated overall and by health care sector and ACP documentation type.Results. The audit included 2285 people, of whom 1082 were eligible for the survey. Of 507 who completed the survey (response rate ¼ 47%), 272 (54%) reported completing ACP documentation, of whom 130 (48%) had documentation identified in the audit. Conversely, 39 of 235 people (17%) who reported not completing ACP documentation had documentation identified (concordance rate ¼ 64%; k ¼ 0.303, P <.001). The concordance rate increased to 79% when self-reported storage of ACP documentation at the person's current point of care was compared with the existence of the document in their health record (k ¼ 0.510, P < .001). Concordance varied by health care setting and type of ACP documentation.Conclusion. Discrepancies exist between self-reported completion of ACP documentation and the presence of these documents in the health records of older adults, representing a significant patient safety issue. Public education campaigns and improvements to systems for document storage and accessibility are required to support person-centered medical and end-of-life care. J Pain Symptom Manage 2019;58:264e274. Ó

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Challenges of conducting research in long-term care facilities: a systematic review

Cited by 88 publications

References 74 publications

Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff

Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff

Implementing a Clinical Research Program in Long Term Care Facilities: Experiences from the University of Louisville Center Excellence for Research in Infectious Diseases [CERID]

Concordance Between Self-Reported Completion of Advance Care Planning Documentation and Availability of Documentation in Australian Health and Residential Aged Care Services

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