Implementing and disseminating knowledge in the care home setting: a systematic scoping review

Article type
Year
Authors
Thompson Coon J1, Abbott R1, Coxon G2, Day J1, Lang I1, Lourida I1, Pearson M1, Reed N3, Rogers M1, Stein K1, Sugavanam T4, Whear R1
1University of Exeter Medical School, UK
2Devon Care Kite Mark, UK
3PenPIG, University of Exeter Medical School, UK
4University of Plymouth, UK
Abstract
Background: Research continues to increase our knowledge of what can be done to improve the care of residents in care homes, but there is a persistent gap between this knowledge and the care that people receive.

Objectives: To:
1. examine the extent, range, and nature of research on different ways of disseminating and implementing knowledge in terms of:
a. the effectiveness of approaches, and
b. the identification of factors that may help or hinder successful adoption, and
2. to map gaps in the existing literature.

Methods: Fifteen electronic databases were searched from inception to July 2015 and supplemented by additional search methods. Quantitative and qualitative studies addressing dissemination or implementation within the residential care setting were included with no restriction on study design, date, or language of publication. Titles, abstracts, and full texts were screened independently by two reviewers. Data extraction (topic, study design, size and type of setting, type of dissemination or implementation strategy used, types of outcome reported) was performed by one reviewer using a piloted, bespoke data extraction form and checked by a second. Data were tabulated and synthesised descriptively using the 2015 EPOC (Effective Provision of Care) Taxonomy of health system interventions. The resulting evidence map was discussed and developed further with those involved in providing care within the residential care setting.

Results: Of the 5374 citations screened, 225 met the inclusion criteria. Twenty-five papers focussed on the dissemination of knowledge; the remainder described implementation in areas of care including falls prevention (n = 13), pressure ulcers (n = 12), pain (n = 18), dementia (n = 20), continence (n = 14), nutrition/hydration (n = 12), and end of life care (n = 14). Further analysis of the types of implementation strategy used and the mapping of gaps in the evidence is underway.

Conclusions: The review describes the range of dissemination and implementation strategies that have been utilised in care homes and highlights important gaps in the evidence.