Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-23T06:42:28.350Z Has data issue: false hasContentIssue false
  • English
  • Français

The State of Evidence-Based Care in Long-Term Care Institutions: A Provincial Survey*

Published online by Cambridge University Press:  29 November 2010

Julie Richardson ,
Julie Moreland  and
Pat Fox
Julie Richardson
Affiliation:
St. Peter's Hospital
Julie Moreland
Affiliation:
McMaster University
Pat Fox
Affiliation:
McMaster University
Get access Rights & Permissions [Opens in a new window]

Abstract

A provincial survey was undertaken in Ontario, Canada concerning the prevalence of the use of practice guidelines in chronic care and long-term care facilities and the opinions of staff about the clinical conditions or problems important for developing clinical practice guidelines and the factors that promote change in clinical practice. Five hundred and fifty surveys were sent out and 306 returned from two mailings. Forty per cent of the facilities were aware of evidence-based guidelines while only 21.6 per cent were using them. They were being used most in government-funded agencies, then in acute care facilities with chronic care beds and nursing homes and least in non-government funded agencies. The clinical problems which agencies felt were important for guideline development were behavioural problems, continence, feeding problems and problems with skin care. The results of this survey have implications for funding of these institutions as well as for identifying the situations where evidence is needed for future care and where it is presently available but not being utilized and understanding the reasons for this approach to practice.

Résumé

En Ontario (Canada), on a mené une enquête sur l'importance du recours aux directives cliniques dans les établissements de maladies chroniques et de soins de longue durée et de la prise en compte de l'opinion du personnel en matière de conditions cliniques ou de problèmes reliés au développement des directives de pratique clinique et sur les facteurs qui initient les changements de la pratique clinique. Cinq cent cinquante questionnaires ont été envoyés en deux étapes et 306 d'entre eux ont été retournés. Quarante pour cent des établissements connaissaient les directives fondées sur les résultats mais seulement 21,6 pour cent les utilisaient. Elles sont surtout utilisées par les organismes financés par le gouvernement, plus par les établissements de soins aigus qui disposent de lits pour les malades chroniques et par les centres d'accueil et moins par les organismes qui ne sont pas financés par le gouvernement. Les problèmes cliniques que les organismes jugent les plus importants pour l'élaboration des directives sont les problèmes de comportement, l'incontinence, les problèmes d'alimentation et les problèmes de soins de la peau. Les conclusions du sondage pourront servir à fixer le financement des établissements et à déterminer les cas où il faudra fonder les soins sur les résultats et ceux où l'on dispose de résultats sur lesquels constituer les soins sans toutefois s'y fier et pour comprendre les raisons de cette approche.

Keywords

Evidence-Based PracticeLong-Term CareSurvey.Pratiques fondée sur les résultatssoins de longue duréeenquête.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 20 , Issue 3 , Automne/Fall 2001 , pp. 357 - 372
Copyright
Copyright © Canadian Association on Gerontology 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agency for Health Care Policy and Research (AHCPR). (1995). Using clinical practice guidelines to evaluate quality of care. Vol 1, 3–8.Google Scholar
Anderson, C. (1994). Measuring what works in health care. Science, 263, 1080–1082.CrossRefGoogle ScholarPubMed
Béland, F., & Arweiler, D. (1996). Conceptual framework for the development of long-term care policy-constitutive elements. Canadian Journal on Aging, 15(4), 649–671.CrossRefGoogle Scholar
Bircumshaw, D. (1990). The utilization of research findings in clinical nursing practice. Journal of Advanced Nursing, 15, 1272–1280.CrossRefGoogle ScholarPubMed
Bohannon, R.W., & Le Veau, B.F. (1986). Clinicians' use of research findings: a review of literature with implications for physical therapists. Physical Therapy, 66, 45–50.CrossRefGoogle ScholarPubMed
Chronic Care Role Study. (1993, March). Project Report. Vols. 1&2. Submitted to the Chronic Care Role Study Steering Committee. Hundert & Associates. Toronto, ON.Google Scholar
Davis, D.A., Thomson, M.A., Oxman, A.D., & Haynes, R.B. (1995). Changing physician performance. A systematic review of the effect of continuing medical education strategies. Journal of the American Medical Association, 274(9), 700–705.CrossRefGoogle ScholarPubMed
Ellrodt, G., Cook, D.J., Lee, J., Cho, M., Hunt, D., & Weingarten, S. (1997). Evidence-based disease management. Journal of the American Medical Association, 278, 1687–1692.CrossRefGoogle ScholarPubMed
Evidence Based Resource Group. (1994a). Evidence Based Care, 2: Setting guidelines: How should we manage this problem? Canadian Medical Association Journal, 150, 1417–1423.Google Scholar
Evidence Based Resource Group. (1994b). Evidence Based Medicine, 5: Lifelong learning: How can we learn to be more effective? Canadian Medical Association Journal, 150, 1971–1973.Google Scholar
Evidence-Based Medicine. (1995). Canadian Medical Association Journal, 151, 201–202.Google Scholar
Frantz, R.A., Gardner, S., Harvey, P., & Specht, J. (1992). Adoption of research-based practice for treatment of pressure ulcers in long term care. Decubitus, 5, 44–54.Google ScholarPubMed
Fune, L., Shua-Haim, J.R., Ross, J.S., & Frank, E. (1999). Infectious disease among residents of nursing homes. Annals of Long-Term Care, 7(11), 410–417.Google Scholar
Funk, S.G., Champagne, M.T., Wiese, R.A., & Tornquist, E.M. (1991). Barriers to using research findings in practice: The clinician's perspective. Applied Nursing Research, 4, 90–95.CrossRefGoogle ScholarPubMed
Garnick, D.W., Hendricks, A.M., & Brennan, T.A. (1991). Can practice guidelines reduce the number and costs of malpractice claims? Journal of the American Medical Association, 266, 2856–2860.CrossRefGoogle ScholarPubMed
Griffith, D. (1987). Ritual pursuits. Nursing Times, 68.Google ScholarPubMed
Guyatt, G.H. (1992). Evidence-based medicine — a new approach to teaching the practice of medicine. Journal of the American Medical Association, 268, 2420–2425.CrossRefGoogle Scholar
Haynes, R.B. (1995). Evidence-based medicine: Improving the link between sound clinical research and practice. Presentation at the 52nd Annual Meeting of the American Geriatrics Society, Washington, DC.Google Scholar
Hogan, D.B. (1999). Research in geriatric medicine: review of the published abstracts of the Canadian Society of Geriatric Medicine. (1981–1998), Annales CRMC, 32, 152–156.Google Scholar
Hunt, J. (1981). Indicators for nursing practice: the use of research findings. Journal of Advanced Nursing, 6, 189–194.CrossRefGoogle ScholarPubMed
Institute of Medicine. (1990). Clinical practice guideline: Directions for a new program. Washington, DC: National Academy Press.Google Scholar
Leipzig, R.M. (1998). That was the year that was: An evidence-based clinical geriatrics update. Journal of the American Geriatrics Society, 46, 1040–1049.CrossRefGoogle ScholarPubMed
Moore, A. (1995). Evidence-based medicine in geriatrics. Presentation at the 52nd Annual Meeting of the American Geriatrics Society, Washington, DC.Google Scholar
Rockwood, K., Bergman, H., Hogan, D.B., & McCracken, P. (1998). Aging-related clinical and health services research in Canada. Journal of the American Geriatrics Society, 46, 1469–1472.CrossRefGoogle ScholarPubMed
Rudberg, M.A., Barr, G., Cassel, C.K., Hayward, R.S., Sussman, E.J., & Roizen, M.F. (1994). Guidelines, practice policies, and parameters: the case for geriatrics. Journal of the American Geriatrics Society, 42(8), 809–815.CrossRefGoogle ScholarPubMed
Sackett, D.L. (1994, May/June). The Cochrane collaboration. ACP Journal Club, A11–A12.CrossRefGoogle ScholarPubMed
Stetler, C.B. (1989). A strategy for teaching research use. Nurse Educator, 13, 17–20.CrossRefGoogle Scholar
Stuck, A.E., Sui, A.L., Wieland, G.D, & Adams, J. (1993). Comprehensive geriatric assessment — a metaanalysis of controlled trials. Lancet, 342, 1032–1036.CrossRefGoogle ScholarPubMed
Tanenbaum, S.J. (1993). Sounding board: what physicians know. New England Journal of Medicine, 329, 1268–1270.CrossRefGoogle Scholar
Titler, M.G., Klieber, C, Steelman, V., Goode, C, Rakel, B., Barry-Walker, J., Small, S., & Buckwalter, K. (1994). Infusing research into practice to promote quality care. Nursing Research, 43, 307–313.CrossRefGoogle ScholarPubMed
Tornquist, E.M., Funk, S.G., & Champagne, M.T. (1989). Writing research reports for clinical audiences. Western Journal of Nursing Research, 11, 576–582.CrossRefGoogle ScholarPubMed
Weed, L.L. (1991). Knowledge coupling: New premises and new tools for medical care and education. New York: Springer-Verlag.CrossRefGoogle Scholar
Wilson-Barnett, J., Corner, J., & De Carle, B. (1990). Integrating nursing research and practice — the role of the researcher as teacher. Journal of Advanced Nursing, 15, 621–625.CrossRefGoogle ScholarPubMed