Recognising and responding to acute deterioration in care home residents: a scoping review
Abstract Background Acute deterioration describes a rapid change in physical and/or mental health resulting from an acute illness – e.g., heart attack or infection. Older people in care homes are some of the frailest and vulnerable in society. They have complex health needs, experience multiple long...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-04082-y |
| _version_ | 1797789565412442112 |
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| author | Sevim Y. Hodge Mohammad R. Ali Ada Hui Pip Logan Adam L. Gordon |
| author_facet | Sevim Y. Hodge Mohammad R. Ali Ada Hui Pip Logan Adam L. Gordon |
| author_sort | Sevim Y. Hodge |
| collection | DOAJ |
| description | Abstract Background Acute deterioration describes a rapid change in physical and/or mental health resulting from an acute illness – e.g., heart attack or infection. Older people in care homes are some of the frailest and vulnerable in society. They have complex health needs, experience multiple long-term conditions (MLTC) and have weakened immune systems due to the ageing process. They are more susceptible to acute deterioration and delayed recognition and response, is linked to poorer health outcomes, adverse events and death. Over the past five years, the need to manage acute deterioration in care homes and prevent hospital admissions has led to development and implementation of improvement projects, including the use of hospital derived practices and tools to identify and manage this condition. This is potentially problematic as care homes are different from hospitals—options to escalate care vary throughout the UK. Further, hospital tools have not been validated for use in care homes and have shown to be less sensitive in older adults living with frailty. Objectives To collate the available evidence on how care home workers recognise and respond to acute deterioration in residents using published primary research, non-indexed and grey literature, policies, guidelines and protocols. Methods A systematic scoping review was conducted following Joanna Briggs Institute (JBI) scoping review methodology. Searches were conducted using: CINAHL (EBSCOhost), EMCARE (OVID), MEDLINE (OVID) and HMIC (OVID). Snowball searches of included studies’ reference lists were conducted. Studies that featured care homes with or without nursing and provided 24/7 care to residents were included. Results Three hundred and ninety-nine studies were identified. After reviewing all studies against inclusion criteria, n = 11 were included in the review. All studies used qualitative methods and were conducted in Australia, UK, South Korea, USA and Singapore. Four themes were generated from the review: identifying residents with acute deterioration; managing acute deterioration, care home policies and procedures, and factors affecting recognition and response to acute deterioration. Findings Recognition and response to acute deterioration in residents is determined by multiple factors and is context sensitive. There are several interrelated factors within and external to the care home that contribute to how acute deterioration is recognised and managed. Conclusions and Implications The available literature on how care home workers recognise and respond to acute deterioration is limited and often subtends other areas of interest. Recognising and responding to acute deterioration in care home residents is reliant on a complex and open system encompassing multiple interrelated components. The phenomenon of acute deterioration remains underexplored and further research is required to examine contextual factors that accompany identification and management of this condition in care home residents. |
| first_indexed | 2024-03-13T01:52:28Z |
| format | Article |
| id | doaj.art-69c4425ccb7a4fbf88d25cb313ed59c7 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-13T01:52:28Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-69c4425ccb7a4fbf88d25cb313ed59c72023-07-02T11:26:24ZengBMCBMC Geriatrics1471-23182023-06-0123112010.1186/s12877-023-04082-yRecognising and responding to acute deterioration in care home residents: a scoping reviewSevim Y. Hodge0Mohammad R. Ali1Ada Hui2Pip Logan3Adam L. Gordon4School of Medicine, Centre for Rehabilitation and Ageing Research, University of NottinghamDepartment of Cardiovascular Sciences, University of LeicesterSchool of Health Sciences, University of NottinghamSchool of Medicine, Centre for Rehabilitation and Ageing Research, University of NottinghamDivision of Medical Sciences and Graduate Entry Medicine, University of NottinghamAbstract Background Acute deterioration describes a rapid change in physical and/or mental health resulting from an acute illness – e.g., heart attack or infection. Older people in care homes are some of the frailest and vulnerable in society. They have complex health needs, experience multiple long-term conditions (MLTC) and have weakened immune systems due to the ageing process. They are more susceptible to acute deterioration and delayed recognition and response, is linked to poorer health outcomes, adverse events and death. Over the past five years, the need to manage acute deterioration in care homes and prevent hospital admissions has led to development and implementation of improvement projects, including the use of hospital derived practices and tools to identify and manage this condition. This is potentially problematic as care homes are different from hospitals—options to escalate care vary throughout the UK. Further, hospital tools have not been validated for use in care homes and have shown to be less sensitive in older adults living with frailty. Objectives To collate the available evidence on how care home workers recognise and respond to acute deterioration in residents using published primary research, non-indexed and grey literature, policies, guidelines and protocols. Methods A systematic scoping review was conducted following Joanna Briggs Institute (JBI) scoping review methodology. Searches were conducted using: CINAHL (EBSCOhost), EMCARE (OVID), MEDLINE (OVID) and HMIC (OVID). Snowball searches of included studies’ reference lists were conducted. Studies that featured care homes with or without nursing and provided 24/7 care to residents were included. Results Three hundred and ninety-nine studies were identified. After reviewing all studies against inclusion criteria, n = 11 were included in the review. All studies used qualitative methods and were conducted in Australia, UK, South Korea, USA and Singapore. Four themes were generated from the review: identifying residents with acute deterioration; managing acute deterioration, care home policies and procedures, and factors affecting recognition and response to acute deterioration. Findings Recognition and response to acute deterioration in residents is determined by multiple factors and is context sensitive. There are several interrelated factors within and external to the care home that contribute to how acute deterioration is recognised and managed. Conclusions and Implications The available literature on how care home workers recognise and respond to acute deterioration is limited and often subtends other areas of interest. Recognising and responding to acute deterioration in care home residents is reliant on a complex and open system encompassing multiple interrelated components. The phenomenon of acute deterioration remains underexplored and further research is required to examine contextual factors that accompany identification and management of this condition in care home residents.https://doi.org/10.1186/s12877-023-04082-yCare homesAcute deteriorationResidentsRecognition & responseManaging acute care in residents |
| spellingShingle | Sevim Y. Hodge Mohammad R. Ali Ada Hui Pip Logan Adam L. Gordon Recognising and responding to acute deterioration in care home residents: a scoping review BMC Geriatrics Care homes Acute deterioration Residents Recognition & response Managing acute care in residents |
| title | Recognising and responding to acute deterioration in care home residents: a scoping review |
| title_full | Recognising and responding to acute deterioration in care home residents: a scoping review |
| title_fullStr | Recognising and responding to acute deterioration in care home residents: a scoping review |
| title_full_unstemmed | Recognising and responding to acute deterioration in care home residents: a scoping review |
| title_short | Recognising and responding to acute deterioration in care home residents: a scoping review |
| title_sort | recognising and responding to acute deterioration in care home residents a scoping review |
| topic | Care homes Acute deterioration Residents Recognition & response Managing acute care in residents |
| url | https://doi.org/10.1186/s12877-023-04082-y |
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