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Implementing guidelines in nursing homes: a systematic review.

Heinz Diehl¹, Birgitte Graverholt², Birgitte Espehaug²

¹Centre for Evidence-Based Practice, Bergen University College, Inndalsveien 58, 5063, Bergen, Norway. htd@fritha.org.

BMC Health Services Research

|July 27, 2016

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Implementing clinical guidelines in nursing homes is challenging due to limited research. This systematic review found inconclusive evidence for interventions, highlighting the need for more nursing home implementation research.

Area of Science:

Gerontology
Healthcare Management
Evidence-Based Practice

Background:

Guideline implementation research is often not transferable to nursing home settings.
Limited evidence exists on effective strategies for nursing home guideline implementation.
Nursing homes require tailored approaches to improve care quality.

Purpose of the Study:

To systematically review the effects of interventions aimed at improving guideline implementation in nursing homes.
To synthesize evidence on the effectiveness of various implementation strategies in this specific setting.

Main Methods:

Systematic literature search across multiple databases (Cochrane Library, CINAHL, Embase, MEDLINE, etc.) up to August 2015.
Inclusion of studies evaluating guideline implementation strategies in nursing homes, including systematic reviews, RCTs, and observational designs.

Keywords:

Guideline implementation Knowledge translation Nursing homes Systematic review

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Multi-Modal Home Sleep Monitoring in Older Adults

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Published on: January 26, 2019

Risk of bias assessment using EPOC tool and evidence quality rating with GRADE.

Main Results:

Five cluster-randomized controlled trials evaluating six multifaceted implementation strategies were included.
One study showed a small effect on professional practice; two showed small to moderate effects on patient outcomes.
The overall quality of evidence was rated as low or very low using GRADE.

Conclusions:

Current evidence on improving guideline implementation in nursing homes is inconclusive.
Further implementation research is crucial to enhance the quality of care in nursing homes.
Specific, effective strategies for nursing home guideline implementation remain to be identified.