Investigating a Critical Practice Question Through a Literature Review Paper

Investigating a Critical Practice Question Through a Literature Review Paper

Date: 06/02/2022		EBP Question: How do caregivers keep patients with dementia safe in home-based care settings?
Article Number	Author and Date	Evidence Type	Sample, Sample Size, Setting Struggling to meet your deadline ? Get assistance on Investigating a Critical Practice Question Through a Literature Review Paper done on time by medical experts. Don’t wait – ORDER NOW! Meet My Deadline or Not Applicable	Findings That Help Answer the EBP Question	Observable Measures	Limitations	Evidence Level, Quality
1.	Cheng, S., Au, A., Losada, A., Thompson, L., & Gallagher-Thompson, D. (2019)	Literature Review	Not applicable	The study revealed that psychoeducation, counseling, psychotherapy, and mindfulness-based interventions enhance safety for patients with dementia.	Researchers reviewed the literature regarding four interventions: psychoeducation, counseling and psychotherapy, multicomponent interventions, and mindfulness-based interventions.	Conflicting findings regarding the effectiveness of these interventions Limited knowledge of patient safety approaches Information ambiguity	Level V (good quality)
2.	Clemson, L., Laver, K., Jeon, Y., Comans, T., Scanlan, J., & Rahja, M. et al. (2018)	Mixed research design	One hundred three patients with dementia and their caregivers (dyads). Dementia care services in Australia	The study revealed that effective planning, patient education, process restructuring, and quality improvement initiatives increase caregivers’ knowledge reduce anxiety and depression that compromise the quality of care of patients with dementia.	The study evaluated four Dyadic interventions; Plan, education, restructure, and quality management.	Conflicting information regarding the effectiveness of the four measures in improving caregivers’ knowledge.	Level III (Good quality)
3.	Grobosch, S., Wolf, F., Juchems, S., & Kuske, S. (2020).	Systematic review	26 articles selected for review	The study revealed that enhancing emotional safety for patients with dementia is essential for promoting patient safety.	The research included five measures: emotional safety as a primary psychological need, emotional safety in the context of disease-related factors, inner conditions and strategies, outer conditions and strategies, and emotional safety as a condition.	Insufficient quantitative data to support the conclusion Many studies did not focus on emotional safety as the primary topic	Level III (High/good quality)
4.	Häikiö, K., Sagbakken, M., & Rugkåsa, J. (2019).	Exploratory study	23 Family caregivers for older adults with dementia in Norway	The research revealed that caregivers should prevent physical, economic, emotional, and social harm to ensure patient safety for patients with dementia.	The study evaluated four measures: physical, emotional, economic, and relational harm.	The study did not include the patients’ perspectives. Potential differing opinions from patients and caregivers may hamper the research’s validity.	Level III (High/good quality).
5.	Handley, M., Bunn, F., & Goodman, C. (2017).	A Realist Review	Twenty-eight studies identified in phases 1, 2 & 3 from PubMed, CINAHL, Cochrane Library, NHS evidence, Scopus, and grey literature.	The study revealed the need to maximize the impact of staff training to enable caregivers to provide person-centered care for people with dementia.	The study included staff training and education measures, the use of person-centered care, dementia champion, and environmental adaptation.	There was limited evidence to support the program theory, especially where interventions lacked specificity about the process and patient outcomes.	Level III (High/Good quality).
6.	Kuske, S., Borgmann, S., Wolf, F., & Bleck, C. (2021).	A Descriptive Qualitative Study	32 interview participants	The study highlights the relevance of ensuring emotional safety for people with dementia. Therefore, caregivers should promote more integrative strategies to guarantee emotional safety for patients with dementia.	The researchers used various measures to analyze emotional safety; the feeling of loneliness/togetherness, physical safety, stress, and patients’ perceptions of well-being.	Difficulties in differentiating between the perspectives of the participants. Few patients with dementia participated in focus groups and feedback groups due to concerns related to having dementia.	Level III (High/Good quality).

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Attach a reference list with full citations of articles reviewed for this EBP question.

Date: 06/02/2022		EBP Question: How do caregivers keep patients with dementia safe in home-based care settings?
Article Number	Author and Date	Evidence Type	Sample, Sample Size, Setting or Not Applicable	Findings That Help Answer the EBP Question	Observable Measures	Limitations	Evidence Level, Quality
7.	Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., & Banerjee, S. et al. (2020).	Commission Report	Not Applicable	The report concludes that fulfilling social needs for patients with dementia is one of the profound approaches for ensuring patient safety.	The report focuses on various risk factors for dementia, including hypertension, inactivity, diabetes, social contact, education levels, obesity, smoking, and depression.	Potentially overlapping causal relationships between risk factors and dementia may compromise the report’s validity. Additional research is necessary to elaborate on synergies between the identified risk factors and dementia.	Level IV (High quality)
8.	Poulos, C., Bayer, A., Beaupre, L., Clare, L., Poulos, R., & Wang, R. et al. (2017)	Systematic review	Not Applicable	The study proposes using the reablement approach that supports rehabilitation, person-centered care, and appropriate support for people with dementia.	The study focuses on various domains for people with dementia. These domains include cognitive disability, physical functions, acute injuries, assistive technology, and caregivers’ support.	The study does not explain the effectiveness of reablement approaches	Level III (High Quality).
9.	Sagbakken, M., Nåden, D., Ulstein, I., Kvaal, K., Langhammer, B., & Rognstad, M. (2017)	A qualitative, descriptive, and explorative study	Eleven participants from four nursing homes with special units for patients with dementia in Oslo, Norway.	The study revealed that maintaining social links between healthcare institutions and home-based caregivers prevents many factors that threaten dignified care for patients with dementia.	The study focused on the following topics: caregivers’ cooperation with health institutions, environmental factors, daily life activities, maintenance of dignity, and organizational situations.	The study involved a small sample, compromising its validity and generalizability.	Level III (High Quality)
10.	Thyrian, J., Hertel, J., Wucherer, D., Eichler, T., Michalowsky, B., & Dreier-Wolfgramm, A. et al. (2017)	Randomized Clinical Trial (RCT)	Six hundred thirty-four people with dementia in Mecklenburg-Western Pomerania, Germany.	The study emphasizes the importance of implementing a collaborative care model for patients with dementia. Interdisciplinary collaboration between trained nurses and home-based caregivers is essential in promoting patient safety for people with dementia.	The research included the following measures; Quality of life, caregiver burden, behavioral and psychological symptoms of dementia, pharmacotherapy of antidementia drugs, and the use of potentially inappropriate medication.	Imbalances between the intervention and control groups may compromise the generalizability of the findings.	Level I (High quality)
11.	Zonsius, M., Cothran, F., & Miller, J. (2020)	Case Report	Not applicable	The study suggests that effective collaboration between nurses and other caregivers can improve treatment for older adults with dementia in any setting.	The highlights strategies for incorporating the 4Ms of Age-Friendly Healthcare Systems into nursing practice: Medication, Mentation, mobility, and what matters to the patient.	The study lacks backing from experimental studies	Level V (Good quality)
12	Zucchella, C., Sinforiani, E., Tamburin, S., Federico, A., Mantovani, E., & Bernini, S. et al. (2018).	A Narrative Review	Studies from PubMed and Cochrane databases (number not stated)	The study indicates the importance of embracing non-pharmacologic treatment (NPT) interventions such as motor rehabilitation, psychological and occupational therapy, assistive technology, telemedicine, psychological therapy, and communication technologies in promoting safety for patients with dementia.	The study includes behavioral and psychological symptoms of dementia, motor rehabilitation, assistive technology, and telemedicine.	The narrative study design proves ineffective because of many studies regarding non-pharmacologic interventions and dementia. The researchers used only two databases, reducing the comprehensiveness of information.	Level III (Good quality)

References

Cheng, S., Au, A., Losada, A., Thompson, L., & Gallagher-Thompson, D. (2019). Psychological interventions for dementia caregivers: What we have achieved, what we have learned. Current Psychiatry Reports, 21(7), 1-12. https://doi.org/10.1007/s11920-019-1045-9

Clemson, L., Laver, K., Jeon, Y., Comans, T., Scanlan, J., & Rahja, M. et al. (2018). Implementation of an evidence-based intervention to improve the well-being of people with dementia and their carers: Study protocol for ‘Care of People with dementia in their Environments (COPE)’ in the Australian context. BMC Geriatrics, 18(1), 1-11. https://doi.org/10.1186/s12877-018-0790-7

Grobosch, S., Wolf, F., Juchems, S., & Kuske, S. (2020). Emotional safety of people living with dementia: A systematic review. Journal Of Mental Health, 1-22. https://doi.org/10.1080/09638237.2020.1739241

Häikiö, K., Sagbakken, M., & Rugkåsa, J. (2019). Dementia and patient safety in the community: A qualitative study of family carers’ protective practices and implications for services. BMC Health Services Research, 19(1), 1-13. https://doi.org/10.1186/s12913-019-4478-2

Handley, M., Bunn, F., & Goodman, C. (2017). Dementia-friendly interventions to improve the care of people living with dementia admitted to hospitals: A realist review. BMJ Open, 7(7), e015257. https://doi.org/10.1136/bmjopen-2016-015257

Kuske, S., Borgmann, S., Wolf, F., & Bleck, C. (2021). Emotional safety in the context of dementia: A multiperspective qualitative study. Journal Of Alzheimer’s Disease, 79(1), 355-375. https://doi.org/10.3233/jad-201110

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., & Banerjee, S. et al. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413-446. https://doi.org/10.1016/s0140-6736(20)30367-6

Poulos, C., Bayer, A., Beaupre, L., Clare, L., Poulos, R., & Wang, R. et al. (2017). A comprehensive approach to reablement in dementia. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 3(3), 450-458. https://doi.org/10.1016/j.trci.2017.06.005

Sagbakken, M., Nåden, D., Ulstein, I., Kvaal, K., Langhammer, B., & Rognstad, M. (2017). Dignity in people with frontotemporal dementia and similar disorders — a qualitative study of the perspective of family caregivers. BMC Health Services Research, 17(1), 1-11. https://doi.org/10.1186/s12913-017-2378-x

Thyrian, J., Hertel, J., Wucherer, D., Eichler, T., Michalowsky, B., & Dreier-Wolfgramm, A. et al. (2017). Effectiveness and safety of dementia care management in primary care. JAMA Psychiatry, 74(10), 996-1004. https://doi.org/10.1001/jamapsychiatry.2017.2124

Zonsius, M., Cothran, F., & Miller, J. (2020). CE: Acute care for patients with dementia. AJN, American Journal of Nursing, 120(4), 34-42. https://doi.org/10.1097/01.naj.0000660024.45260.1a

Zucchella, C., Sinforiani, E., Tamburin, S., Federico, A., Mantovani, E., & Bernini, S. et al. (2018). The multidisciplinary approach to Alzheimer’s disease and dementia. A narrative review of non-pharmacological treatment. Frontiers In Neurology, 9, 1-22. https://doi.org/10.3389/fneur.2018.01058

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The Assignment
Part 1: Literature Review (10+ scholarly articles)
Using the Walden Library as your source, search to select at least 10 scholarly articles that represent current literature (i.e., published within the previous 5 years) with evidence that addresses your critical question and could inform a practice change initiative for quality improvement. Using the Individual Evidence Summary Tool template document, complete all sections for each article.
Part 2: Critical Assessment (7+ pages)
In a paper of at least 7 pages, plus cover page and references page, include the following:
• Write a critical assessment of your search outcomes that synthesizes the evidence from your literature review.
• Demonstrate clear connections between the practice problem that informs your critical question, your appraisal of evidence that addresses the critical question, and resulting clarification on the need for a practice change initiative focusing on quality improvement. Be specific and provide examples.
Critical Question: How do we keep dementia patients safe in the healthcare setting and in their homes?