Heart failure in nursing homes: A scoping review of educational interventions for optimising care provision

IF 3.1 Q1 NURSING
James McMahon , David R. Thompson , Jan Cameron , Christine Brown Wilson , Loreena Hill , Paul Tierney , Doris Yu , Debra K. Moser , Karen Spilsbury , Nittaya Srisuk , Jos M. G. A. Schols , Mariëlle van der Velden , Gary Mitchell
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引用次数: 0

Abstract

Background

Heart failure has an estimated global prevalence of 64.3 million cases, with an average age of a person living with heart failure at 75.2 years. Approximately 20% of residents living in nursing homes (a long-term residential care environment for some individuals) report living with heart failure. Residents living with heart failure in nursing home environments are often frail, have reduced quality of life, higher rates of rehospitalisation and mortality, and greater complications in heart failure management. Further, nursing home staff often lack the knowledge and skills required to provide the necessary care for those living with heart failure. Interventions for improving heart failure management in nursing homes have proven effective, yet there is a lack of understanding regarding interventions for optimising care provision. The aim of this review was to synthesise the current evidence on educational interventions to optimise care provided to people with heart failure in nursing homes.

Methods

A scoping review with four databases searched: Medline, CINAHL, Web of Science, and EMBASE. Relevant reference lists were searched manually for additional records. Studies of nursing home staff or resident outcomes associated with changes in care provision (i.e., resident quality of life, staff knowledge of heart failure) were included. Results from the charting data process were collated into themes: intervention outcomes, changes to practice, and implementation and process evaluation.

Results

Seven papers were deemed eligible for inclusion. Most studies (n=6) were comprised of nursing home staff only, with one comprised only of residents. Study aims were to improve heart failure knowledge, interprofessional communication, heart failure assessment and management. Positive changes in staff outcomes were observed, with improvements in knowledge, self-efficacy, and confidence in providing care reported. No difference was reported concerning nursing home resident outcomes. Interprofessional communication and staff ability to conduct heart failure assessments improved post-intervention. Changes to practice were mixed, with issues around sustainability reported. Nursing home staff highlighted their appreciation towards receiving education, recommending that videos, images, and humour could improve the intervention content.

Conclusions

There is a paucity of evidence around educational interventions to support residents living with heart failure in nursing homes. However, available evidence suggests that educational interventions in nursing homes may improve care through improving staff self-efficacy and confidence in providing care, heart failure knowledge and interprofessional communication. The complexity of implementing educational interventions in the nursing home setting must be considered during the development process to improve implementation, effectiveness, and sustainability.

疗养院中的心力衰竭:为优化护理服务而采取的教育干预措施范围综述
背景据估计,心力衰竭在全球的发病率为 6430 万例,心力衰竭患者的平均年龄为 75.2 岁。约有 20% 住在疗养院(某些人的长期居住护理环境)的人报告患有心力衰竭。在疗养院环境中生活的心力衰竭患者通常身体虚弱、生活质量下降、再住院率和死亡率较高,心力衰竭治疗的并发症也较多。此外,疗养院工作人员往往缺乏为心衰患者提供必要护理所需的知识和技能。事实证明,改善疗养院心衰管理的干预措施是有效的,但人们对优化护理服务的干预措施还缺乏了解。本综述旨在综合目前有关教育干预措施的证据,以优化为疗养院中的心力衰竭患者提供的护理:Medline、CINAHL、Web of Science 和 EMBASE。人工检索了相关参考文献列表,以获取更多记录。纳入了与护理服务变化相关的疗养院员工或住院患者结果的研究(即住院患者的生活质量、员工对心力衰竭的认识)。图表数据处理结果按主题进行整理:干预结果、实践变化以及实施和过程评估。大多数研究(n=6)仅由疗养院员工参与,其中一篇仅由居民参与。研究目的是提高心力衰竭知识、加强专业间沟通、改进心力衰竭评估和管理。研究结果表明,员工在提供护理的知识、自我效能和信心方面都有积极的变化。在疗养院居民的疗效方面没有发现差异。干预后,专业间的沟通和员工进行心衰评估的能力都有所提高。实践方面的变化参差不齐,据报告还存在可持续性方面的问题。疗养院员工强调了他们对接受教育的感激之情,并建议视频、图片和幽默可以改善干预内容。然而,现有证据表明,养老院中的教育干预措施可以通过提高员工的自我效能和提供护理的信心、心衰知识和专业间沟通来改善护理。在开发过程中必须考虑到在养老院环境中实施教育干预的复杂性,以提高实施效果、有效性和可持续性。
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来源期刊
CiteScore
5.80
自引率
0.00%
发文量
45
审稿时长
81 days
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