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. 2020 May;34(5):558-570.
doi: 10.1177/0269216319893635. Epub 2020 Feb 3.

Strategies for the implementation of palliative care education and organizational interventions in long-term care facilities: A scoping review

Danni Collingridge Moore  1 , Sheila Payne  1 , Lieve Van den Block  2 , Julie Ling  3 , Katherine Froggatt  1 ; PACE
Collaborators, Affiliations

Strategies for the implementation of palliative care education and organizational interventions in long-term care facilities: A scoping review

Danni Collingridge Moore et al. Palliat Med. 2020 May.

Abstract

Background: The number of older people dying in long-term care facilities is increasing; however, care at the end of life can be suboptimal. Interventions to improve palliative care delivery within these settings have been shown to be effective in improving care, but little is known about their implementation.

Aim: The aim of this study was to describe the nature of implementation strategies and to identify facilitators and/or barriers to implementing palliative care interventions in long-term care facilities.

Design: Scoping review with a thematic synthesis, following the ENTREQ guidelines.

Data sources: Published literature was identified from electronic databases, including MEDLINE, EMBASE, PsycINFO and CINAHL. Controlled, non-controlled and qualitative studies and evaluations of interventions to improve palliative care in long-term care facilities were included. Studies that met the inclusion criteria were sourced and data extracted on the study characteristics, the implementation of the intervention, and facilitators and/or barriers to implementation.

Results: The review identified 8902 abstracts, from which 61 studies were included in the review. A matrix of implementation was developed with four implementation strategies (facilitation, education/training, internal engagement and external engagement) and three implementation stages (conditions to introduce the intervention, embedding the intervention within day-to-day practice and sustaining ongoing change).

Conclusion: Incorporating an implementation strategy into the development and delivery of an intervention is integral in embedding change in practice. The review has shown that the four implementation strategies identified varied considerably across interventions; however, similar facilitators and barriers were encountered across the studies identified. Further research is needed to understand the extent to which different implementation strategies can facilitate the uptake of palliative care interventions in long-term care facilities.

Keywords: Long-term care facilities; care homes; end-of-life care; implementation; intervention; literature review; nursing homes; palliative care; palliative medicine; scoping review.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
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