Journal
GERONTOLOGIST
Volume 61, Issue 3, Pages E61-E74Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/geront/gnz145
Keywords
Analysis-systematic review; Decision making; Institutional care; residential care; Nursing homes; Workforce issues; Long-term care; Missed care; Prioritization
Categories
Funding
- Macquarie University Research Training Program Scholarship
- Australian Institute of Health Innovation project: Exploring complexity to create a sustainable health care system, National Health and Medical Research Council Partnership Centre grant in Health System Sustainability [9100002]
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This study examines the types and associated factors of unfinished care in RACFs, emphasizing that policymakers and providers can reduce unfinished care by focusing on modifiable factors such as staffing levels. Four key knowledge gaps were identified for future research directions.
Background and Objectives: When workload demands are greater than available time and resources, staff members must prioritize care by degree of importance and urgency. Care tasks assigned a lower priority may be missed, rationed, or delayed; collectively referred to as unfinished care. Residential aged care facilities (RACFs) are susceptible to unfinished care due to consumers' complex needs, workforce composition, and constraints placed on resource availability. The objectives of this integrative review were to investigate the current state of knowledge of unfinished care in RACFs and to identify knowledge gaps. Research Design and Methods: We conducted a search of academic databases and included English-language, peer-reviewed, empirical journal articles that discussed unfinished care in RACFs. Data were synthesized using mind mapping techniques and frequency counts, resulting in two categorization frameworks. Results: We identified 17 core studies and 27 informing studies (n = 44). Across core studies, 32 types of unfinished care were organized under five categories: personal care, mobility, person-centeredness, medical and health care, and general care processes. We classified 50 factors associated with unfinished care under seven categories: staff member characteristics, staff member well-being, resident characteristics, interactions, resources, the work environment, and delivery of care activities. Discussion and Implications: This review signifies that unfinished care in RACFs is a diverse concept in terms of types of unfinished care, associated factors, and terminology. Our findings suggest that policymakers and providers could reduce unfinished care by focusing on modifiable factors such as staffing levels. Four key knowledge gaps were identified to direct future research.
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