Here is the structured PICO analysis for the nineteenth article you uploaded:
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Full Title (verbatim and exact):
“Development of a clinical pathway for behavioural and psychological symptoms of dementia care: A tool to improve resident outcomes”
Kennedy KJ, Eckert M, Forsythe D, Wagner J, Sharplin G
Australasian Journal on Ageing (2022); 41:e291–e297
DOI: https://doi.org/10.1111/ajag.13093
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Type of Article:
Development study – description of the design and creation of a draft clinical pathway, not a trial
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PICO Analysis:
Population:
- Residents of Australian residential aged care facilities (RACFs) living with dementia, including those experiencing behavioural and psychological symptoms of dementia (BPSD)
- Pathway developed for use by nurses and personal care workers within RACFs
Intervention:
- Development of a draft clinical pathway for BPSD management based on best practice evidence, intended to:
- Standardise BPSD prevention, assessment, and intervention
- Promote non-pharmacological strategies first
- Provide guidance for safe pharmacological use when necessary
- Includes colour-coded flowcharts and an instruction guide outlining:
- Risk assessment
- Preventative care
- Watchful waiting (mild–moderate risk)
- Escalation (high risk)
- Pharmacological intervention procedures
- Pathway is tailored to include person-centred care, with clear procedures for:
- Care planning and review
- Staff education
- Family and allied health involvement
- Internal and external referrals (e.g., GP, DBMAS, SBRT)
Comparator:
- No comparison group
- This is a development and feasibility-focused paper; no control or usual care comparison was made
Outcome:
1. Person-centred outcomes:
- Intended outcomes include:
- Reduction in BPSD severity
- Improved quality of life for residents
- Enhanced engagement with non-pharmacological strategies
- Reduced use of antipsychotic medication and physical restraint
2. Process outcomes:
- Structured risk-based framework to guide clinical decisions
- Improved staff clarity and confidence in responding to BPSD
- Focus on early intervention and documentation
- Pathway designed to be feasible, usable, and implementable
3. Health system outcomes:
- Anticipated outcomes include:
- Decreased inappropriate antipsychotic use
- Standardisation of dementia care practices in RACFs
- Improved interdisciplinary collaboration
- Not formally measured in this development phase; pilot testing and feasibility assessments are planned as next steps
Summary Conclusion:
This study describes the development of a draft clinical pathway to support Australian RACF staff in managing BPSD with a consistent, evidence-informed, and person-centred approach. The pathway integrates multiple best practice sources and provides a clear framework to guide non-pharmacological and pharmacological responses to BPSD based on assessed risk. While no clinical outcomes are yet measured, the pathway aims to reduce care variation, enhance safety, and improve quality of life for residents with dementia. Feasibility testing in a memory support unit is planned, followed by broader pilot testing.
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