To review current evidence on the implementation and impact of virtual nursing care in long-term aged care.
An integrative rapid literature review.
Medline, CINAHL, Web of Science, Embase, Ageline and Scopus.
The review included studies involving virtual care interventions provided by nurses (or by a multidisciplinary team including nurses) to older people in residential aged care that reported health outcomes or stakeholder experiences. Consistent with PRISMA guidelines, databases were systematically searched in July and August 2024, focusing on literature published since 2014. Studies were screened in Covidence by three team members, with conflicts resolved by additional reviewers. Studies not involving nurses or not set in aged care were excluded.
The search identified 13 studies, which included quantitative, qualitative and mixed-method approaches, conducted in both Australian and international settings, as well as in rural and metropolitan locations. Nurses were often involved as part of an existing virtual care programme, typically located in a hospital setting. The training and credentials of nurses delivering VN varied in terms of specialisation and advanced practice. The model of care in general was ad hoc, though in some cases there were regular, scheduled VN consultations. The time requirements for onsite staff and nurses were not well articulated in any of the studies, and information on the funding models used was also lacking.
There is some evidence that VN interventions in aged care may improve communication, enhance person-centred care and reduce emergency department presentations and hospitalisations.
Rigorous, ongoing evaluation of VN interventions is required to ensure their appropriate application in residential aged care.
Alcohol consumption that damages health remains highly prevalent in Sweden despite macrolevel intervention measures such as availability, restrictions and taxation. As understanding of behaviour change develops, there may be an opportunity to enhance individual level interventions by targeting personal dimensions of behaviour, such as underlying motives for drinking alcohol and readiness to change behaviour. This protocol describes a randomised controlled trial aimed at estimating the effectiveness of an intervention tailored to motives and readiness to change.
A three-arm, parallel groups, randomised controlled trial will be used to estimate the effects of a motives and readiness to change tailored intervention. We will use a Bayesian sequential design to decide when to stop recruitment, with target criteria for benefit, harm and futility. Recruitment will be completed via web adverts and social media. Inclusion criteria are being aged 18 or older, having access to a mobile phone and being classified as a risky drinker. Participants allocated to the two intervention groups will receive either a personalised digital intervention or an intervention with enhanced tailoring for motives and readiness to change. The personalised intervention consists of weekly screening, personalised feedback and tools for planning behaviour. The enhanced tailored version will follow the same logic but will contain materials tailored for individuals’ drinking motives and readiness to change. The control group will be redirected to two national websites with information about alcohol and health. Outcome measures are weekly alcohol consumption and monthly heavy drinking episodes, which will be contrasted with regression models and estimated using Bayesian inference.
Ethical approval was obtained from the Swedish Ethical Review Authority on 16 April 2024, (Dnr 2024-01630-01). The results of the study will be disseminated in academic journals and research conferences.
The trial was preregistered in the ISRCTN Registry on 12 June 2024 (ISRCTN87600318).