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OP68 Implementing and disseminating best practice in the care home setting: A systematic scoping review
  1. J Thompson Coon1,
  2. R Abbott1,
  3. G Coxon2,
  4. J Day1,
  5. I Lang1,
  6. I Lourida1,
  7. M Pearson1,
  8. N Reed3,
  9. M Rogers1,
  10. K Stein1,
  11. P Sugavanam4,
  12. R Whear1
  1. 1NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
  2. 2Pottles Court Residential Home, Exminster, UK
  3. 3PenPIG, NIHR CLAHRC South West Peninsula (PenCLAHRC) University of Exeter Medical School, Exeter, UK
  4. 4NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Plymouth, Plymouth, UK

Abstract

Background Research continues to increase our knowledge of what can be done to improve the care of those resident in care homes but there is a persistent gap between this knowledge and the care that people actually receive. The aims of this scoping review are, first, to examine the extent, range, and nature of research on different ways of disseminating and implementing research findings in terms of (a) the effectiveness of approaches and (b) the identification of factors that may help or hinder successful adoption and, second, to identify and map gaps in the existing literature.

Methods Fifteen electronic databases were searched from inception to July 2015. Backward and forward citation searching was conducted and websites of relevant organisations were searched to identify unpublished material. Quantitative and qualitative studies addressing dissemination or implementation within the residential care setting were included with no restriction on study design, date, or language of publication. Titles, abstracts, and full texts were screened independently by two reviewers. Data extraction (topic, study design, size and type of setting, type of dissemination or implementation strategy used, types of outcome reported) was performed by one reviewer using a piloted, bespoke data extraction form and checked by a second. Discrepancies at all stages were resolved by discussion with arbitration by a third reviewer where necessary. Data were tabulated and synthesised descriptively using the EPOC taxonomy to classify the type (professional, organisational, financial or regulatory) of strategies used, and the approach taken. Protocol registration: CRD42015025094

Results Of the 5374 citations screened, 4811 and 303 were excluded on the basis of title and abstract and full-text respectively; 260 met the inclusion criteria. Less than 10% of papers focussed on the dissemination of knowledge; the remainder describe implementation in areas of care including falls prevention, pressure ulcers, pain, dementia, incontinence, nutrition, and vaccination uptake. Eighty percent of papers were published in the last ten years and approximately 50% report factors that may help or hinder the dissemination and implementation of best practice in this setting derived predominantly from qualitative interviews and focus groups. Further analysis of the types of implementation strategy used and the mapping of gaps in the evidence is underway.

Conclusion The review describes the range of dissemination and implementation strategies that have been utilised in care homes and highlights important gaps in the evidence. The findings will inform the focus of future dissemination and implementation research.

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