Resident-to-resident elder mistreatment in residential aged care services : a systematic review of event frequency, type, resident characteristics, and history
- Authors: Woolford, Marta , Stacpoole, Susan , Clinnick, Lisa
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Journal of the American Medical Directors Association Vol. 22, no. 8 (2021), p. 1678-1691.e6
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- Description: Objectives: Resident-to-resident elder mistreatment (R-REM) between residents living in residential aged care (RAC) services is a challenging issue in relation to the care of older people. Evidence suggests that R-REM, such as verbal, physical, and sexual conflict between residents, is a common and pervasive issue. This review examines the frequency with which R-REM occurs in RAC services; identifies the types of R-REM that occur; and provides an overview of the reported characteristics of both the victim and perpetrator involved in the R-REM event. Design: A systematic review was conducted. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Ageline, and Cochrane Library to identify qualitative and quantitative studies published in the English language. Setting and Participants: Residents living in RAC services. Measures: Data on frequency and characteristics were collated, and aggregate proportions were calculated where possible. Results: Twenty-six studies were identified; most (n = 20) were published in the United States. The overall proportion of residents engaged in R-REM was provided by 7 quantitative studies with the estimated frequency reported to be 12% to 23%. For qualitative studies, the number of care staff reporting to have observed R-REM ranged from 18.7% to 98.0%. Physical and verbal abuse were the most commonly reported types of mistreatment. Characteristics of the perpetrator of R-REM were reported in 12 (46.2%) studies. Overall, the mean age of perpetrators was 80.93 years, most were men (83.2%), and 64.4% had dementia and/or Alzheimer diagnosis. Characteristics of the victim and the history of R-REM were largely omitted from the published studies. Conclusion and Implications: The findings from the review broaden understanding on the extent of R-REM; the individual and event characteristics and ultimately support care planning, policy, and direction for future research. To improve understanding, quality of care, and RAC residents’ well-being, further studies are recommended to address the identified gaps in knowledge. © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
Managing patient deterioration: assessing teamwork and individual performance
- Authors: Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Missen, Karen , Sparkes, Louise , McConnell-Henry, Tracy , Endacott, Ruth
- Date: 2013
- Type: Text , Journal article
- Relation: Emergency Medicine Journal Vol. 30, no. 5 (2013), p.
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- Description: Objective To assess the ability of rural Australian nurse teams to manage deteriorating patients. Methods This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Results Knowledge in relation to patient deterioration management varied (mean 63%, range 27–100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17–83%, SD 14.03) with significantly higher levels in younger participants (r=−0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Conclusion Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.
Mixed methods research: a design for emergency care research?
- Authors: Cooper, Simon J. , Porter, Joanne , Endacott, Ruth
- Date: 2010
- Type: Text , Journal article
- Relation: Emergency Medicine Journal Vol. 28, no. (2010), p. 682-685
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- Description: This paper follows previous publications on generic qualitative approaches, qualitative designs and action research in emergency care by this group of authors. Contemporary views on mixed methods approaches are considered, with a particular focus on the design choice and the amalgamation of qualitative and quantitative data emphasising the timing of data collection for each approach, their relative ‘weight’ and how they will be mixed. Mixed methods studies in emergency care are reviewed before the variety of methodological approaches and best practice considerations are presented. The use of mixed methods in clinical studies is increasing, aiming to answer questions such as ‘how many’ and ‘why’ in the same study, and as such are an important and useful approach to many key questions in emergency care.
Qualitative Research: Specific designs for qualitative research in emergency care?
- Authors: Cooper, Simon J. , Chapman, Ysanne , Endacott, Ruth
- Date: 2009
- Type: Text , Journal article
- Relation: Emergency Medicine Journal Vol. 26, no. (2009), p. 773-776
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- Description: This article follows our description of generic qualitative approaches, focusing on the specific designs of ethnography, grounded theory and phenomenology. Distinguishing features are described, including methodological approaches and methods for enhancing rigour. The use of these designs in emergency care is unusual but informative, and important work has been produced. Whether used in a pure or applied manner, it is likely that such approaches will add to our understanding of the emergency world.