Interventions to improve care quality in long-term care facilities for older adults: An umbrella review protocol
Creators: name: Poncin, Emmanuelle
name: de Goumoëns, Véronique
name: Kiszio, Blanche
name: Van Grootven, Bastiaan
name: Ortoleva Bucher, Claudia
name: Roulet Schwab, Delphine
name: Curreri, Nereide Alhena
name: Osińska, Magdalena
name: Corna, Laurie
name: Zúñiga, Franziska
name: Wellens, Nathalie IH
Publisher: name: Zenodo
Year: 2023
Subjects: quality of health care; long-term care; aged; malnutrition; pain; pressure ulcer; polypharmacy; restraint, physical; advance care planning; medication review; umbrella review

description: <strong>Background: </strong>As part of sustained efforts to improve the quality of care and meet the challenges associated with ageing, Swiss long-term care facilities for older people are under a legal obligation to report quality indicators to the federal authorities. Whilst a vast amount of literature focuses on individual quality indicator areas, knowledge is scattered and not readily actionable, which makes it difficult for policymakers and practitioners in long-term care facilities to improve current practices based on the best available evidence. Against this backdrop, this umbrella review will identify and describe effective interventions to: improve monitoring, assessment, care, raise awareness, and/or reduce the prevalence of malnutrition, pain, or pressure ulcers in older adults residing in long-term care facilities; improve care practices by reducing polypharmacy or the use of physical restraints or by improving the coverage and effects of advance care planning or medication reviews in long-term care facilities for older adults. <strong>Methods: </strong>We will follow the Joanna Briggs Institute (JBI) guidelines for umbrella reviews. We will include systematic reviews and meta-analyses based on empirical evidence published between 2013 and 2023. We will search the following databases: Medline (Ovid), CINHAL (EBSCO), PsycINFO (Ovid), Emcare (Ovid), Embase (Elsevier), Cochrane Library, JBI EBP Database (Ovid), Web of Science, Epistemonikos, and Google scholar as a supplementary resource; and Dissertations and Theses (Proquest) and MedNar for grey literature. Two independent reviewers will screen titles and abstracts then full texts of selected reviews, using inclusion criteria based on a Population–Interventions–Context–Outcomes (PICO) framework. We will assess methodological quality to include only high-quality reviews and use the standardised JBI tool to extract relevant data. A descriptive narrative summary will present main findings in relation to effective interventions in the areas of malnutrition, pain, pressure ulcers, polypharmacy, physical restraints, advance care planning, and medication reviews in long-term care facilities for older adults. <strong>Discussion: </strong>Our findings will present a synthesis of the literature on key quality indicators areas, which will be helpful in guiding policymakers and practitioners in the development, implementation, and sustainment of evidence-based care quality improvement initiatives.
description: This work is conducted and funded as part of the National Implementation Programme – Strengthening quality of care in partnership with residential long-term care facilities for older people 2022–2026 (NIP-Q-UPGRADE), commissioned by the Swiss Federal Quality Commission (FQC) to ARTISET with the industry association CURAVIVA and senesuisse. It is implemented in collaboration with the Institut für Pflegewissenschaft (INS), Universität Basel, Institut et Haute Ecole de la Santé La Source (La Source), Lausanne, and Scuola universitaria professionale della Svizzera italiana (SUPSI), Manno.