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Factors Influencing Interprofessional Quality Improvement in Nursing Homes: A Systematic Review
Rosanne M Vosters1, Yvonne M J Goërtz1, Daisy J A Janssen2
1Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands; Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Objectives:
Previous studies have investigated quality improvement in the care for older people; however, there remains a need to identify the factors that influence interprofessional quality improvement. This study aims to study the facilitators and barriers for interprofessional quality improvement in the care for older people in nursing homes.
Design:
Systematic literature review (PROSPERO registration number: CRD42024528522).
Setting And Participants:
Interprofessional teams in the care for older people in nursing homes.
Methods:
A systematic search of PubMed, CINAHL, PsycINFO, and Web of Science was performed. Peer-reviewed, original qualitative studies were included that reported on facilitators and/or barriers for quality improvement by teams of at least 2 different disciplines of care professionals in the long-term care for older people in nursing homes. Thematic synthesis was used to identify facilitators and barriers.
Results:
Facilitators and barriers from 35 publications (40 quality improvement projects) were grouped into the following 8 themes: vision, culture, attitude, communication, collaboration, education, resources, and implementation. Within each theme, factors were divided into 5 different levels of influence: resident system, individual, team, organization, and external. The variety of themes and levels of influence shows the complexity of interprofessional quality improvement.
Conclusions And Implications:
The literature shows that interprofessional quality improvement in nursing homes is a complex endeavor. Although the interprofessional team is responsible for quality improvement, the individuals within the team and the organization around the team have an active role in facilitating this process. In addition, quality improvement projects should more actively involve residents and their families.
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