Implementation and evaluation of a pain assessment app and novel community platform for long-term care health professionals

Data Quality of Resident Documentation in Long-Term Care: A Systematic Review and Meta-analysis

OBJECTIVES

To evaluate the impact of interventions aimed at improving data quality in resident documentation in the residential long-term care setting, and to explore the experiences related with the implementation strategies and key determinants influencing data quality.

DESIGN

A systematic review.

SETTING AND PARTICIPANTS

Residential long-term care.

METHODS

PubMed and Embase were searched from inception to January 2025. This search was supplemented with screening study registries, references, prospective citation searching, and reviewing gray literature. Studies were selected and data were abstracted by 2 researchers. A narrative synthesis and random effects meta-analyses were performed. The GRADE level of evidence was determined. A thematic analysis was conducted for the qualitative data.

RESULTS

A total of 30 studies were included. The introduction of electronic health records, educational strategies, incident reporting systems, and reminder strategies were associated with small to moderate improvements. The average effect across interventions was an improvement of 13% (95% CI, 7%-20%, I2 = 60%, very low GRADE) in data completeness. Overall data quality was improved in 3 studies, accuracy of data was improved in 1 study, and 1 study observed a nonsignificant improvement in reliability. Small effect sizes and very low-GRADE evidence were observed. Key determinants influencing data quality included the perceived usefulness of documentation systems, access to electronic health records, staff knowledge about clinical assessments, and perceptions of the appropriateness of quality indicators and data reliability. Implementation of interventions was supported by the following strategies: (1) identify and prepare champions, (2) audit and feedback on implementation, (3) provide ongoing consultation, and (4) disseminate implementation materials.

CONCLUSIONS AND IMPLICATIONS

Small to moderate improvements in data quality were observed, with a very low GRADE of evidence. Most findings were limited to the completeness of documentation, although aspects such as timeliness and accuracy remain understudied. It remains unclear what interventions are effective in ensuring solid data quality.

Initiatives Targeting Health Care Professionals: A Systematic Review of Knowledge Translation Pain Assessment and Management Studies Focusing on Older Adults

OBJECTIVES

Pain is often undertreated in older adult populations due to factors, such as insufficient continuing education and health care resources. Initiatives to increase knowledge about pain assessment and management are crucial for the incorporation of research evidence into practice. Knowledge translation (KT) studies on pain management for older adults and relevant knowledge users have been conducted; however, the wide variety of KT program formats and outcomes underscores a need to evaluate and systematically report on the relevant literature.

MATERIALS AND METHODS

Using a systematic review methodology, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycInfo, and Web of Science databases were searched from inception to June 2023. Pain-related KT programs targeted towards older adults, their informal caregivers, and health care professionals were examined. Initiatives focusing on health care professionals are the focus of this review. Initiatives focusing on older adults are reported in a companion article.

RESULTS

From an initial 21,669 search results, 172 studies met our inclusion criteria. These studies varied widely in focus and delivery format but the majority were associated with significant risk of bias. In this report, we are focusing on 124 studies targeting health care professionals; 48 studies involving initiatives targeting older adults are reported in a companion article. Moreover, most programs were classified as knowledge mobilization studies without an implementation component. Across all studies, knowledge user satisfaction with the initiative and the suitability of the material presented were most commonly assessed. Patient outcomes, however, were underemphasized in the literature.

CONCLUSION

Patient and clinical outcomes must be a focus of future research to fully conceptualize the success of KT programs for older adult individuals. Without implementation plans, disseminated knowledge does not tend to translate effectively into practice.