Associations between hospital organizational features, person‐centred care and nurse‐sensitive outcomes for persons with dementia in acute care: A systematic literature review

Abstract

Aim(s)

The aim of this systematic literature review was to determine the extent and quality of quantitative evidence regarding associations between hospital organizational features, person-centred care (PCC) and nursing-sensitive outcomes among persons with dementia in the acute care setting.

Design

Systematic review.

Methods

Key terms were utilized to guide searches in four databases. The two reviewers deduplicated articles and came to a consensus for the final sample using inclusion and exclusion criteria.

Data Sources

MEDLINE/OVID, CINHAL, COCHRANE and WEB OF SCIENCE.

Results

There were 10 studies included. PCC was associated with better outcomes for persons with dementia (i.e. decreased restraint use, decreased length of stay, increased involvement with families and the patient, and increased nurse confidence and competence in caring for this population). Of the studies, none explicitly identified an association between nursing-sensitive outcomes, PCC and hospital organizational features in the acute care setting among persons with dementia.

Conclusion

This review highlights a clinically significant gap in knowledge regarding associations between hospital organizational features, PCC and nursing sensitive outcomes. The impact of face-to-face dementia competency training as a standard practice among acute care facilities, the importance of leadership engagement, support and involvement to improve nurse confidence and competence in caring for persons with dementia needs to be explored.

Impact Statement

These findings support future research to understand the relationship between organization features and patient-centred care and how these collectively impact nursing-sensitive outcomes, specifically in persons with dementia in acute care settings.

Intervenciones enfocadas a la prevención de la formación de una hernia paraestomal en personas con ostomías de eliminación

Hombre de mediana edad, con vida sedentaria, al que se le practica un estoma de eliminación temporal. Objetivo: Identificar intervenciones consensuadas de autocuidado del paciente, basadas en la evidencia, con criterios de implementación y evaluación, destinadas a la prevención de hernias paraestomales. Metodología: Búsqueda bibliográfica de evidencia científica: Formulación de preguntas clínicas, localización de información, contextualización, (lectura crítica y síntesis de evidencias), implementación y evaluación (modelo PRAXIS: Interconexión de evidencia científica con conocimiento tácito de enfermera clínica, educando en prevención e involucrando al paciente a través de investigación-acción- participativa: Compartencia); Entrevista-recogida de datos de grupo focal para determinar recomendaciones de autocuidado. Resultados principales: 5 RBP y 17 prácticas de autocuidado. Conclusiones: RBP identificadas ampliamente reforzadas con prácticas de autocuidado aportadas por expertas del grupo focal. Problema principal: Adherencia al tratamiento. Se determinaron prácticas sencillas resolutivas. Carencia principal: Necesidad de mayor y mejor soporte psicológico, sexual, fisioterápico y nutricional.