Acute Deterioration in Long‐Term Care: A Delphi Study of Indicators, Care Pathways and Implementation Strategies.
Aim: This study aimed to develop recommendations for acceptable physical and psychological clinical indicators of acute deterioration and strategies to support sustained adoption of an approach to detecting and responding to acute deterioration in long‐term care. Background: Previous studies have tr...
| Publicado en: | International Journal of Nursing Practice (John Wiley & Sons, Inc.) Vol. 32; no. 4; pp. 1 - 14 |
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| Autores principales: | , , , , , , , , |
| Formato: | critical path research tables/charts Journal Article |
| Publicado: |
John Wiley & Sons, Inc.
Aug2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196543671&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196543671 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13227114 LVDW jtl: International Journal of Nursing Practice (John Wiley & Sons, Inc.) issn: 13227114 maglogo: N pubinfo: dt: Aug2026 vid: 32 iid: 4 pid: 52269 pub: John Wiley & Sons, Inc. artinfo: ui: 196543671 196543671 196543671 10.1111/ijn.70166 196543671 ppf: 1 ppct: 13 formats: tig: atl: Acute Deterioration in Long‐Term Care: A Delphi Study of Indicators, Care Pathways and Implementation Strategies. aug: au: Parker, Christina Sriram, Deepa Chambers, Shirley Schnitker, Linda Spooner, Amy Jack, Leanne Yates, Patsy Beattie, Elizabeth MacAndrew, Margaret affil: School of Nursing, Queensland University of Technology, Brisbane Queensland,, Australia sug: subj: Long Term Care Clinical Deterioration Diagnosis Early Diagnosis Consensus Nursing Home Residents Program Implementation Human Delphi Technique Surveys Scales Australia Networking, Professional Clinical Nurse Specialists Nurse Practitioners Physicians, Emergency Registered Nurses Geriatricians Physicians, Family Data Analysis Software Funding Source Confusion Agitation Delusions Hallucinations Delirium ab: Aim: This study aimed to develop recommendations for acceptable physical and psychological clinical indicators of acute deterioration and strategies to support sustained adoption of an approach to detecting and responding to acute deterioration in long‐term care. Background: Previous studies have trialled programmes to reduce avoidable hospital transfers through early detection of acute deterioration in long‐term care. However, variability in outcomes and implementation experiences highlights differences in the essential components of these approaches. Design: Three‐round Delphi process. Methods: The Delphi process conducted between September 2022 and January 2023 included a 22‐member Australian expert panel to elicit consensus and to generate recommendations. Delphi participants were asked to rate the potential items on a 9‐point scale for level of importance (Part A), level of priority of action (Part B) and level of acceptability (Part C). The mean, standard deviation (SD) and I‐CVI of each item were calculated. Clinical indicators with mean ≥ 7, I‐CVI ≥ 0.78 were considered to have a good degree of agreement, appropriateness and relevance and were deemed acceptable for inclusion. Results: Participants completed a two‐part online survey in Round 1, and three‐part surveys in Rounds 2 and 3. Round 1, Part A included 44 clinical indicators. On completion of Round 3, 36 items remained. Care pathways in response to acute deterioration (n = 20) were included in Part B. After Round 3, 17 care pathways remained. There was agreement in Part C that communication aides, education and mentor programmes were necessary as viable strategies to support sustained adoption. Conclusion: Detecting the early warning signs of acute deterioration will have significant outcomes for residents, staff and health care services. Summary: What is already known about this topic Most older adults living in long‐term care (LTC) have complex care needs related to cognitive impairment, multiple chronic conditions, high symptom burden, poor social support and reduced quality of life.Detecting the early warning signs of acute deterioration is essential in preventing further deterioration, avoidable hospitalisation, increased disease burden and premature death. What this paper adds Items have been identified on the early signs of acute deterioration in older people living in LTCConsensus has occurred on recommendations for elements of a programme to build capacity of the LTC workforce to recognise, report and respond to the early signs of acute deterioration of residents. The implications of this paper The recommendations of early warning signs of acute deterioration in LTC in this study will inform the development of an early warning score system.The inclusion of recommendations about pathways in response to acute deterioration, and strategies to support capacity building of the workforce will ensure significant outcomes for residents, staff and health care services. pubtype: Academic Journal doctype: critical path research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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