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护理机构的组织能力建设以促进居民流动性:系统评价。

Organizational Capacity Building in Nursing Facilities to Promote Resident Mobility: A Systematic Review.

机构信息

Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, North Rhine-Westphalia, Germany; Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten, North Rhine-Westphalia, Germany.

Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Witten, Witten, North Rhine-Westphalia, Germany; Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten, North Rhine-Westphalia, Germany.

出版信息

J Am Med Dir Assoc. 2021 Dec;22(12):2408-2424.e12. doi: 10.1016/j.jamda.2021.09.017. Epub 2021 Oct 13.

Abstract

OBJECTIVES

The objective of the present systematic review was to investigate the effects of organizational capacity building interventions on the environment, nursing staff capacity, and mobility of residents in nursing facilities.

DESIGN

Systematic review.

SETTING AND PARTICIPANTS

Nursing facilities, staff, and residents.

METHODS

We conducted a systematic review according to the methods of the Cochrane Collaboration. The systematic review was prospectively registered in the PROSPERO database of systematic reviews (registration number CRD42020202996). We searched for studies in MEDLINE (via PubMed), CINAHL (via EBSCO), the Physiotherapy Evidence Database (PEDro), and the Cochrane Library (07/20). A narrative synthesis was conducted because of the high heterogeneity of the included studies.

RESULTS

We identified 6747 records and included 14 studies in our review. We clustered the 14 interventions into 3 different categories (environmental modification, nursing staff capacity, and multifactorial interventions). Three studies assessed outcomes at the nursing staff level, and all studies reported outcomes at the resident level. We found highly heterogeneous and inconsistent effects of organizational capacity building on increasing nursing staff capacity and/or resident mobility.

CONCLUSIONS AND IMPLICATIONS

The findings emphasize the need for further research focusing on an international understanding and definition of organizational capacity building. Additionally, research and intervention development for organizational capacity building interventions to promote resident mobility are needed while applying the framework of the Medical Research Council. Furthermore, studies should assess outcomes regarding the environment and nursing staff to better understand if and how environmental structures and nursing staff capacity effect resident mobility.

摘要

目的

本系统评价的目的是调查组织能力建设干预对环境、护理人员能力和护理设施居民流动性的影响。

设计

系统评价。

设置和参与者

护理设施、工作人员和居民。

方法

我们根据 Cochrane 协作组织的方法进行了系统评价。该系统评价在 PROSPERO 系统评价数据库(注册号 CRD42020202996)中进行了前瞻性注册。我们在 MEDLINE(通过 PubMed)、CINAHL(通过 EBSCO)、物理治疗证据数据库(PEDro)和 Cochrane 图书馆(07/20)中搜索了研究。由于纳入研究的高度异质性,我们进行了叙述性综合分析。

结果

我们确定了 6747 条记录,并在我们的综述中纳入了 14 项研究。我们将 14 项干预措施分为 3 个不同类别(环境改造、护理人员能力和多因素干预)。三项研究评估了护理人员层面的结果,所有研究都报告了居民层面的结果。我们发现组织能力建设对提高护理人员能力和/或居民流动性的影响高度异质且不一致。

结论和意义

研究结果强调需要进一步研究,重点是对组织能力建设的国际理解和定义。此外,需要研究和制定组织能力建设干预措施,以促进居民流动性,同时应用医学研究委员会的框架。此外,研究应评估与环境和护理人员有关的结果,以更好地了解环境结构和护理人员能力是否以及如何影响居民流动性。

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