Patient experiences of codesigned rehabilitation interventions in hospitals: a rapid review

McKercher, Jonathan P; Slade, Susan C; Jazayeri, Jalal; Hodge, Anita; Knight, Matthew; Green, Janet; Woods, Jeffrey; Thwaites, Claire; Morris, Meg E.

doi:10.1136/bmjopen-2022-068241

Cited by 8 publications

(5 citation statements)

References 45 publications

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“…For example, fear of falling is one risk factor for future falls that might lead to avoidance of interventions. 90 In addition to patient‐centered factors, extrinsic factors such as staffing, non‐evidence‐based health facility policies, or failure to adequately engage consumers in therapy co‐design 53 , 56 , 91 can interfere with falls prevention. 55 During the pandemic many service providers pivoted to online PD interventions aimed at improving access and safety.…”

Section: Resultsmentioning

confidence: 99%

Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

Camicioli

Morris

Pieruccini‐Faria

et al. 2023

Movement Disord Clin Pract

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BackgroundPeople living with Parkinson's disease (PD) have a high risk for falls.ObjectiveTo examine gaps in falls prevention targeting people with PD as part of the Task Force on Global Guidelines for Falls in Older Adults.MethodsA Delphi consensus process was used to identify specific recommendations for falls in PD. The current narrative review was conducted as educational background with a view to identifying gaps in fall prevention.ResultsA recent Cochrane review recommended exercises and structured physical activities for PD; however, the types of exercises and activities to recommend and PD subgroups likely to benefit require further consideration. Freezing of gait, reduced gait speed, and a prior history of falls are risk factors for falls in PD and should be incorporated in assessments to identify fall risk and target interventions. Multimodal and multi‐domain fall prevention interventions may be beneficial. With advanced or complex PD, balance and strength training should be administered under supervision. Medications, particularly cholinesterase inhibitors, show promise for falls prevention. Identifying how to engage people with PD, their families, and health professionals in falls education and implementation remains a challenge. Barriers to the prevention of falls occur at individual, environmental, policy, and health system levels.ConclusionEffective mitigation of fall risk requires specific targeting and strategies to reduce this debilitating and common problem in PD. While exercise is recommended, the types and modalities of exercise and how to combine them as interventions for different PD subgroups (cognitive impairment, freezing, advanced disease) need further study.This article is protected by copyright. All rights reserved.

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Section: Resultsmentioning

confidence: 99%

Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

Camicioli

Morris

Pieruccini‐Faria

et al. 2023

Movement Disord Clin Pract

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“…Regarding the domains the intervention aimed to influence, some studies focused on the single domain of education (n = 11) [50,51,55,57,58,62,64] while most focused on multiple domains which combined education with recruitment, retention and/or safety. Seven studies included consumer engagement or co-design, as defined by McKercher et al (2022) [5], while none of the studies included an economic evaluation. Meta-analysis was not appropriate due to the heterogeneity of the intervention, the included workforce, the setting, the study design, and the outcome measures.…”

Section: Resultsmentioning

confidence: 99%

“…The workforce are increasingly required to innovate and improve services and adapt new technologies. Care workers also need to address the increasing divergence of consumer needs (including clients, patients family members and other informal carers) and ensure that consumers have a voice in their own care [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Professional care workforce: a rapid review of evidence supporting methods of recruitment, retention, safety, and education

Morris,

Brusco,

McAleer

et al. 2023

Hum Resour Health

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Background Across the care economy there are major shortages in the health and care workforce, as well as high rates of attrition and ill-defined career pathways. The aim of this study was to evaluate current evidence regarding methods to improve care worker recruitment, retention, safety, and education, for the professional care workforce. Methods A rapid review of comparative interventions designed to recruit, retain, educate and care for the professional workforce in the following sectors: disability, aged care, health, mental health, family and youth services, and early childhood education and care was conducted. Embase and MEDLINE databases were searched, and studies published between January 2015 and November 2022 were included. We used the Quality Assessment tool for Quantitative Studies and the PEDro tools to evaluate study quality. Results 5594 articles were initially screened and after applying the inclusion and exclusion criteria, 30 studies were included in the rapid review. Studies most frequently reported on the professional nursing, medical and allied health workforces. Some studies focused on the single domain of care worker education (n = 11) while most focused on multiple domains that combined education with recruitment strategies, retention strategies or a focus on worker safety. Study quality was comparatively low with a median PEDro score of 5/10, and 77% received a weak rating on the Quality Assessment tool for Quantitative Studies. Four new workforce strategies emerged; early career rural recruitment supports rural retention; workload management is essential for workforce well-being; learning must be contextually relevant; and there is a need to differentiate recruitment, retention, and education strategies for different professional health and care workforce categories as needs vary. Conclusions Given the critical importance of recruiting and retaining a strong health and care workforce, there is an immediate need to develop a cohesive strategy to address workforce shortfalls. This paper presents initial evidence on different interventions to address this need, and to inform care workforce recruitment and retention. Rapid Review registration PROSPERO 2022 CRD42022371721 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022371721

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“…Unlike prior reviews [ 5 , 15 ], we evaluated the extent to which patients were involved in clinical guideline development. Patient-centred care is now a key pillar of healthcare [ 72 , 73 ], and it was surprising that only two of the included falls guidelines mentioned patients, families or members of the public in the design, evaluation or updating of guidelines. This is arguably a serious gap because most falls prevention strategies in hospitals directly rely on patient engagement (e.g.…”

Section: Discussionmentioning

confidence: 99%

Hospital falls clinical practice guidelines: a global analysis and systematic review

McKercher,

Peiris,

Hill

et al. 2024

Age and Ageing

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Background Hospital falls continue to be a persistent global issue with serious harmful consequences for patients and health services. Many clinical practice guidelines now exist for hospital falls, and there is a need to appraise recommendations. Method A systematic review and critical appraisal of the global literature was conducted, compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Web of Science, Embase, CINAHL, MEDLINE, Epistemonikos, Infobase of Clinical Practice Guidelines, Cochrane CENTRAL and PEDro databases were searched from 1 January 1993 to 1 February 2024. The quality of guidelines was assessed by two independent reviewers using Appraisal of Guidelines for Research and Evaluation Global Rating Scale and Appraisal of Guidelines of Research and Evaluation Recommendation Excellence (AGREE-REX). Certainty of findings was rated using Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative Research. Data were analysed using thematic synthesis. Results 2404 records were screened, 77 assessed for eligibility, and 20 hospital falls guidelines were included. Ten had high AGREE-REX quality scores. Key analytic themes were as follows: (i) there was mixed support for falls risk screening at hospital admission, but scored screening tools were no longer recommended; (ii) comprehensive falls assessment was recommended for older or frail patients; (iii) single and multifactorial falls interventions were consistently recommended; (iv) a large gap existed in patient engagement in guideline development and implementation; (v) barriers to implementation included ambiguities in how staff and patient falls education should be conducted, how delirium and dementia are managed to prevent falls, and documentation of hospital falls. Conclusion Evidence-based hospital falls guidelines are now available, yet systematic implementation across the hospital sector is more limited. There is a need to ensure an integrated and consistent approach to evidence-based falls prevention for a diverse range of hospital patients.

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Patient experiences of codesigned rehabilitation interventions in hospitals: a rapid review

Cited by 8 publications

References 45 publications

Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

Prevention of Falls in Parkinson's Disease: Guidelines and Gaps

Professional care workforce: a rapid review of evidence supporting methods of recruitment, retention, safety, and education

Hospital falls clinical practice guidelines: a global analysis and systematic review

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