Evidence map›Paper›PMID 40090869›Full record

ArticleJournal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing2025

Detection of Acute Deterioration in Care Home Residents: A Multicenter Qualitative Exploration of Barriers and Enablers.

Margaret MacAndrew, Deepa Sriram, Shirley Chambers, Amy Spooner, Linda Schnitker, Leanne Jack, Patsy Yates, Elizabeth Beattie, Christina Parker

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Margaret MacAndrewSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.ORCID 0000-0002-3724-9980
Deepa SriramSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Shirley ChambersSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.ORCID 0000-0001-9652-9440
Amy SpoonerSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Linda SchnitkerSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Leanne JackSchool of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia.
Patsy YatesSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Elizabeth BeattieSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Christina ParkerSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.ORCID 0000-0003-3834-205X

Funding

Queensland Government Nursing and Midwifery Research Fellowship
6 · The paper itself

Abstract

introductionDelay in detecting acute deterioration in older adults in care homes is associated with avoidable hospitalizations and adverse outcomes, including premature death.

objectiveUnderpinned by the Knowledge to Action Framework, this study aimed to understand the barriers and enablers to direct care staff detecting and responding to the early signs of acute deterioration in care home residents. STUDY

designOnline focus groups or interviews with regulated (registered and enrolled nurses) and unregulated (assistants in nursing and personal care workers) direct care staff from participating care homes were conducted. Homes were recruited using disproportionate stratified random sampling to include metropolitan, inner regional, and outer regional care homes. Interview and focus group recordings were transcribed verbatim and analyzed using inductive thematic analysis.

resultsEighty direct care staff (n = 48 regulated; n = 32 unregulated) from eight care homes participated. Fifteen focus groups (n = 7 unregulated staff, n = 8 regulated staff) and two interviews (n = 1 regulated staff, n = 1 unregulated staff) were conducted between July 2021 and October 2022. Four themes related to the barriers and enablers of detecting and responding to acute deterioration were generated: decision-making within the scope of practice; resource availability; streamlined communication; and teamwork.

conclusionFindings highlight the challenges direct care staff encounter in being able to detect early signs of acute deterioration and implement appropriate care pathways. Perceived barriers and enablers highlighted in this study need to be considered when developing and implementing programs to optimize the timely detection of, and response to, acute deterioration in care homes. CLINICAL RELEVANCE: Workforce knowledge, experience, and confidence deficits are significant barriers to detecting acute deterioration, while the unique workforce mix in care homes poses additional challenges for the accurate detection of early signs of acute deterioration. Knowing the resident, working as a team, and valuing the contribution of aged care staff and families in managing acute deterioration are enablers to achieving better outcomes for residents experiencing acute deterioration.

Indexed as

Clinical DeteriorationNursing HomesAgedFemaleFocus GroupsHomes for the AgedHumansMaleMiddle AgedQualitative Researchacute deteriorationaged carecare homescare pathwaysnursing

Identifiers

PMID40090869
PMCPMC12241764

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.