Life In The Slower Lane

This page will be dedicated to the process of undertaking the scoping review. The methodology has been registered in Open Science Framework.

https://osf.io/r86wy/?view_only=d1dec5d2a98340e58b12180bbd7d4989

The literature search outputs were entered into Covidence for abstract screening.

The results are that 207 included articles required secondary PICO screening to ensure the accuracy of inclusion.

The research question remains: What are the benefits, barriers, and enablers of implementing acute care pathways in Residential Aged Care Homes?

Based on the JBI method of conducting a scoping review, and the Khalil article on Conducting high quality scoping reviews the following principles have been followed;

1. Establish a Clear and Comprehensive Protocol:Clearly define an a priori protocol to guide the scoping review, which includes specific objectives, inclusion and exclusion criteria, and planned methods for screening and extracting data. This helps avoid ambiguity and enhances transparency and replicability.
2. Explicitly Define the Purpose and Scope:Clearly articulate the reasons for conducting your scoping review, such as mapping research in a specific area, clarifying concepts, identifying knowledge gaps, or informing systematic reviews. This ensures the review remains focused and meets its intended objectives.
3. Use Rigorous and Transparent Methodology:Adhere to recognized methodological frameworks such as the JBI methodology or Arksey and O’Malley’s framework. Apply rigorous methods for searching databases, selecting studies, charting data, and collating findings, maintaining transparency throughout.
4. Engage Stakeholders in the Review Process:Involving stakeholders (e.g., practitioners, policymakers, patients) throughout the review process can enhance the relevance and applicability of the findings, helping to inform more meaningful implications for research, policy, and practice.
5. Address Reporting Challenges Proactively:Anticipate and address potential challenges in reporting, such as misunderstandings by journal editors or reviewers about scoping review purposes and outputs. Provide clear explanations about the nature of a scoping review and explicitly state limitations regarding the extent to which results can inform practice and policy.

As part of this process I will here outline my methodology for conducting the secondary abstract, and PICO analysis review by the team. This will be as follows:

• Systematically ensure that each of the 207 references identified by search has an associated PDF file and that a PICO analysis is completed by ChatGPT.
• The PICO analysis and the original document links will be posted on this website, but their links will also be entered into an Excel spreadsheet
• Each reviewer will read the article and confirm that the PICO is accurate or inaccurate.
• Each reviewer will then attest to whether the article is included or excluded from the final full-text analysis.
• Each reviewer will be blinded to the decisions of other reviewers.
• Once all articles are reviewed for PICO appropriateness, and inclusion in final analysis, the next step of the methodology will be added.

1. Rehabilitation, reablement, and restorative care approaches in the aged care sector: a scoping review of systematic reviews.
2. Outreach acute care for nursing homes: an observational study on the quality and cost-effectiveness of the Mobile Hospital.
3. Using the Recommended Summary Plan for Emergency Care and Treatment in Primary Care: a mixed methods study.
4. Appropriateness of Nursing Home to Emergency Department Transitional Care for Older Adults With Dementia: A Scoping Review.
5. Implementation of an antimicrobial stewardship program for urinary tract infections in long-term care facilities: a cluster-controlled intervention study.
6. Implementation and evaluation of the Supportive and Palliative Care Indicators Tool (SPICT) in acute care.
7. Models for delivery and co-ordination of primary or secondary health care (or both) to older adults living in aged care facilities.
8. Reducing unplanned hospital admissions from care homes: a systematic review.
9. Factors impacting resident outcomes from COVID-19 outbreaks in Residential Aged Care Facilities in Sydney Local Health District: testing an infection prevention and control scoring system.
10. What interventions keep older people out of nursing homes? A systematic review and meta-analysis.
11. Recognising and responding to acute deterioration in care home residents: a scoping review.
12. Building a Program Theory of Implementation Using Process Evaluation of a Complex Quality Improvement Trial in Nursing Homes.
13. Pneumonia-Associated Emergency Transfers, Functional Decline, and Mortality in Nursing Home Residents.
14. Does telehealth influence the decision to transfer residents of residential aged care facilities to emergency departments? A scoping review.
15. Factors associated with increased Emergency Department transfer in older long-term care residents: a systematic review.
16. Effectiveness of a complex regional advance care planning intervention to improve care consistency with care preferences: study protocol for a multi-center, cluster-randomized controlled trial focusing on nursing home residents (BEVOR trial).
17. Change in Advance Care Plans of Nursing Home Residents With Dementia and Pneumonia: Secondary Analysis of Randomized Controlled Trial Data.
18. The effects of advance care planning intervention on nursing home residents: A systematic review and meta-analysis of randomised controlled trials.
19. Development of a clinical pathway for behavioural and psychological symptoms of dementia care: A tool to improve resident outcomes.
20. A multimodal intervention to optimise antimicrobial use in residential aged care facilities (ENGAGEMENT): protocol for a stepped-wedge cluster randomised trial.
21. BABEL (Better tArgeting, Better outcomes for frail ELderly patients) advance care planning: a comprehensive approach to advance care planning in nursing homes: a cluster randomised trial.
22. Timely short-term specialized palliative care service intervention for older people with frailty and their family carers in primary care: Development and modelling of the frailty+ intervention using theory of change.
23. Development of a clinical pathway for behavioural and psychological symptoms of dementia care: A tool to improve resident outcomes.
24. Context and mechanisms that enable implementation of specialist palliative care Needs Rounds in care homes: results from a qualitative interview study.
25. Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis.
26. Does Integration of Palliative Care and Infection Management Reduce Hospital Transfers among Nursing Home Residents?
27. A rapid response and treatment service for care homes: a case study.
28. Pilot cluster randomised trial of an evidence-based intervention to reduce avoidable hospital admissions in nursing home residents (Better Health in Residents of Care Homes with Nursing-BHiRCH-NH Study).
29. Improving care for residents in long term care facilities experiencing an acute change in health status.
30. Care to the end: a retrospective observational study of aged care facility residents transferred to hospital in the last day of life.
31. Improvements in Antibiotic Appropriateness for Cystitis in Older Nursing Home Residents: A Quality Improvement Study With Randomized Assignment.
32. PACE-IT study protocol: a stepped wedge cluster randomised controlled trial evaluating the implementation of telehealth visual assessment in emergency care for people living in residential aged-care facilities.
33. Wishes and needs of nursing home residents and their relatives regarding end-of-life decision-making and care planning-A qualitative study.
34. Evaluation of the Predictive Accuracy of the interRAI Falls Clinical Assessment Protocol, Scott Fall Risk Screen, and a Supplementary Falls Risk Assessment Tool Used in Residential Long-Term Care: A Retrospective Cohort Study.
35. Developing evidence-based guidance for assessment of suspected infections in care home residents.
36. Evaluation of a Palliative Care Program for Nursing Homes in 7 Countries: The PACE Cluster-Randomized Clinical Trial.
37. Improved Quality of Death and Dying in Care Homes: A Palliative Care Stepped Wedge Randomized Control Trial in Australia.
38. International Transferability of Research Evidence in Residential Long-term Care: A Comparative Analysis of Aged Care Systems in 7 Nations.
39. Introducing Goals of Patient Care in Residential Aged Care Facilities to Decrease Hospitalization: A Cluster Randomized Controlled Trial.
40. Analyzing Hospital Transfers Using INTERACT Acute Care Transfer Tools: Lessons from MOQI.
41. Evidence-based intervention to reduce avoidable hospital admissions in care home residents (the Better Health in Residents in Care Homes (BHiRCH) study): protocol for a pilot cluster randomised trial.
42. Systematic Advance Care Planning and Potentially Avoidable Hospitalizations of Nursing Facility Residents.
43. ‘We DECide optimized’ – training nursing home staff in shared decision-making skills for advance care planning conversations in dementia care: protocol of a pretest-posttest cluster randomized trial.
44. Interventions to Improve Antimicrobial Stewardship for Older People in Care Homes: A Systematic Review.
45. Person-directed care planning in nursing homes: A scoping review.
46. Care home residents admitted to hospital through the emergency pathway: characteristics and associations with inpatient mortality.
47. Implementing advance care planning in nursing homes – study protocol of a cluster-randomized clinical trial.
48. Concordance between Goals of Care and Treatment Decisions for Persons with Dementia.
49. An Advance Care Planning Video Decision Support Tool for Nursing Home Residents With Advanced Dementia: A Cluster Randomized Clinical Trial.
50. Recognition and assessment of resident’ deterioration in the nursing home setting: A critical ethnography.
51. Description of an advance care planning intervention in nursing homes: outcomes of the process evaluation.
52. Effects of two feedback interventions on end-of-life outcomes in nursing home residents with dementia: A cluster-randomized controlled three-armed trial.
53. Predicting hospital transfers among nursing home residents in the last months of life.
54. Effectiveness of advance care planning with family carers in dementia nursing homes: A paired cluster randomized controlled trial.
55. Effects of an Intervention to Reduce Hospitalizations From Nursing Homes: A Randomized Implementation Trial of the INTERACT Program.
56. Implementation of ‘Goals of Patient Care’ medical treatment orders in residential aged care facilities: protocol for a randomised controlled trial.
57. Changes in Care Goals and Treatment Orders Around the Occurrence of Health Problems and Hospital Transfers in Dementia: A Prospective Study.
58. Decisions to Transfer Nursing Home Residents to Emergency Departments: A Scoping Review of Contributing Factors and Staff Perspectives.
59. An Interim Analysis of an Advance Care Planning Intervention in the Nursing Home Setting.
60. Improving comfort in people with dementia and pneumonia: a cluster randomized trial.
61. Implementing guidelines in nursing homes: a systematic review
62. NOT FOUND: Unscheduled care admissions at end-of-life – what are the patient characteristics?
63. Care-Delivery Interventions to Manage Agitation and Aggression in Dementia Nursing Home and Assisted Living Residents: A Systematic Review and Meta-analysis.
64. Effectiveness of the Liverpool care pathway for the dying in residential care homes: An exploratory, controlled before-and-after study.
65. Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach.
66. Evaluation of an advance care planning education programme for nursing homes: A Longitudinal study.
67. Implementing an advance care planning program in German nursing homes: results of an inter-regionally controlled intervention trial.
68. Results of the promoting effective advance care planning for elders (PEACE) randomized pilot study.
69. Agitation in nursing home residents with dementia (VIDEANT trial): effects of a cluster-randomized, controlled, guideline implementation trial.
70. What, why, and how care protocols are implemented in Ontario nursing homes.
71. Acceptability and feasibility of end-of-life care pathways in Australian residential aged care facilities.
72. A systematic review of the effectiveness of advance care planning interventions for people with cognitive impairment and dementia.
73. Can a multifaceted educational intervention targeting both nurses and physicians change the prescribing of antibiotics to nursing home residents? A cluster randomized controlled trial.
74. Interventions for improving palliative care for older people living in nursing care homes.
75. The integrated implementation of two end-of-life care tools in nursing care homes in the UK: an in-depth evaluation.
76. Mixed methods process evaluation of an advance care planning intervention among nursing home staff
77. Effectiveness of advance care planning programmes in improving end-of-life outcomes for individuals with dementia and their caregivers in nursing homes: Protocol for a systematic review and meta-Analysis
78. Enablers and Barriers for End-of-Life Symptom Management Medications in Long-Term Care Homes: A Qualitative Study
79. Antimicrobial prescribing in French nursing homes and interventions for antimicrobial stewardship: a qualitative study
80. Describing the status quo of person-centred dementia care in different types of care units in German nursing homes: A convergent mixed methods study
81. Effects of Advance Care Planning on End-of-Life Indicators for Nursing Home Residents‚ÄîAn Experimental Study with a Retrospective Chart Review
82. Emergency Palliative Care: Early Assessment of an Older Adult With a Fall and Hip Fracture
83. Implementation of an Advance Care Planning Intervention in Nursing Homes: An International Multiple Case Study
84. Measures that matter should define accountability and governance frameworks
85. SPANISH ONLY – Not eligible
86. Desired dementia care towards end of life: Development and experiences of implementing a new approach to improve person-centred dementia care
87. FRENCH ONLY – Not eligible
88. The Effectiveness of Palliative Care Interventions in Long-Term Care Facilities: A Systematic Review
89. Evaluating the implementation fidelity to a successful nurse-led model (INTERCARE) which reduced nursing home unplanned hospitalisations
90. Experiences of nurses working in RACFs and EDs utilising visual telehealth consultation to assess the need for RACF resident transfer to ED: A qualitative descriptive study
91. A Systematic Review of the Effects of Advance Care Planning Interventions in Nursing Homes
92. What are best practices for involving family caregivers in interventions aimed at responsive behaviour stemming from unmet needs of people with dementia in nursing homes: a scoping review
93. How and why educational interventions work to increase knowledge of delirium among healthcare professionals in nursing homes: A protocol for a realist review
94. Accelerating guideline dissemination in nursing homes during the COVID-19 pandemic: A patient-centered randomized controlled trial
95. Acute Health Care Provision in Rural Long-Term Care Facilities: A Scoping Review of Integrated Care Models
96. Accelerating Detection and Intervention for Sepsis in Skilled Nursing Facilities Using a Sepsis Pathway
97. The design and conduct of a pragmatic cluster randomized trial of an advance care planning program for nursing home residents with dementia
98. Not eligible – German only Nursing home-sensitive conditions and approaches to reduce hospitalization of nursing home residents
99. CMS Initiative to Reduce Potentially Avoidable Hospitalizations Among Long-Stay Nursing Facility Residents: Lessons Learned
100. Not eligible – French only
101. Which interventions are effective at decreasing or increasing emergency department attendances or hospital admissions from long-term care facilities? A systematic review
102. Taxonomy of Interventions to Reduce Acute Care Transfers From Long-term Care Homes: A Systematic Scoping Review
103. Implementing advance care planning in Swedish healthcare settings‚ a qualitative study of professionals’ experiences
104. Australian residential aged care home staff experiences of implementing an intervention to improve palliative and end-of-life care for residents: A qualitative study
105. Pragmatic Trials in Long-Term Care: Implementation and Dissemination Challenges and Opportunities
106. Effects of a theory-based advance care planning intervention for nursing homes: A cluster randomized controlled trial
107. The Effect of Advance Care Planning Intervention on Hospitalization Among Nursing Home Residents: A Systematic Review and Meta-Analysis
108. Mechanisms and contextual influences on the implementation of advance care planning for older people in long-term care facilities: A realist review
109. Support for people with dementia experiencing severe responsive behaviours: Unpacking the disconnect between policy and practice
110. Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review
111. Strategies used by care home staff to manage behaviour that challenges in dementia: A systematic review of qualitative studies
112. Does an Integrated Palliative Care Program Reduce Emergency Department Transfers for Nursing Home Palliative Residents?
113. Clinical profile and care pathways – not eligible (french only)
114. Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design
115. Effect of a Video-Assisted Advance Care Planning Intervention on End-of-Life Health Care Transitions Among Long-Stay Nursing Home Residents
116. Enablers and barriers to implementing care quality improvement program in nursing homes in China
117. Facilitating Staff Adoption of New Policies and Procedures in Aged Care Through Training for Readiness for Change
118. Adopting the fall tailoring interventions for patient safety (tips) program to engage older adults in fall prevention in a nursing home
119. Champions for improved adherence to guidelines in long-term care homes: a systematic review
120. Strengthening advance care planning in rural residential aged care through multidisciplinary educational case conferences: A hybrid implementation-effectiveness study
121. Staff Training Interventions to Improve End-of-Life Care of Nursing Home Residents: A Systematic Review
122. Implementing transitional care in skilled nursing facilities: Evaluation of a learning collaborative
123. Palliative and end-of-life care in care homes: Protocol for codesigning and implementing an appropriate scalable model of Needs Rounds in the UK
124. Advance Directives in the Nursing Home Setting: An Initiative to Increase Completion and Reduce Potentially Avoidable Hospitalizations
125. Quality of the diagnostic process, treatment decision, and predictors for antibiotic use in general practice for nursing home residents with suspected urinary tract infection
126. Residential aged care homes: Why do they call ‘000’? A study of the emergency prehospital care of older people living in residential aged care homes
127. A complex intervention to reduce avoidable hospital admissions in nursing homes: A research programme including the BHiRCH-NH pilot cluster RCT
128. Strategies for the implementation of palliative care education and organizational interventions in long-term care facilities: A scoping review
129. Implementation strategies used to implement nursing guidelines in daily practice: A systematic review
130. Evaluation of a novel decision guide ‚Äúgo to the hospital or stay here?‚Äù for nursing home residents and families a randomized trial
131. Improving shared decision-making in advance care planning: Implementation of a cluster randomized staff intervention in dementia care
132. Implementing advance care planning in routine nursing home care: The development of the theory-based ACP+ program
133. Supporting adoption of the palliative approach toolkit in residential aged care: an exemplar of organisational facilitation for sustainable quality improvement
134. Training nursing home staff to improve residents, end-of-life care: design and baseline findings from a randomized controlled trial
135. Not eligible – Dutch only (Is the approach of delirium in dutch nursing-homes in accordance with the national guideline?)
136. Inter-organisational collaboration in palliative care trajectories for nursing home residents: A nation-wide mixed methods study among key persons
137. Understanding implementation fidelity in a pragmatic randomized clinical trial in the nursing home setting:a mixed-methods examination
138. Effectiveness of non-pharmaceutical interventions to prevent falls and fall-related fractures in older people living in residential aged care facilities‚Äìa systematic review and network meta-analysis protocol
139. Nursing Home Characteristics Associated With Implementation of an Advance Care Planning Video Intervention
140. Experiences and involvement of family members in transfer decisions from nursing home to hospital: A systematic review of qualitative research
141. Barriers and Facilitators to Implementing a Pragmatic Trial to Improve Advance Care Planning in the Nursing Home Setting
142. A framework for cross-cultural development and implementation of complex interventions to improve palliative care in nursing homes: The PACE steps to success programme
143. Implementing the theory-based advance care planning ACP+ programme for nursing homes: Study protocol for a cluster randomised controlled trial and process evaluation
144. Advance care planning in nursing homes – Improving the communication among patient, family, and staff: Results from a cluster randomized controlled trial (COSMOS)
145. Normalising and planning for death in residential care: Findings from a qualitative focus group study of a specialist palliative care intervention
146. Stakeholder Perspectives on the Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) Project
147. The advance care planning nurse facilitator: Describing the role and identifying factors associated with successful implementation
148. Avoiding costly hospitalisation at end of life: Findings from a specialist palliative care pilot in residential care for older adults
149. Not eligible (French only): Improving advance care planning in patients with dementia: The effect of training nurses to engage in acp-related conversations
150. Preventing Burdensome Transitions of Nursing Home Residents with Advanced Dementia: It’s More than Advance Directives
151. Symptom relief in patients with pneumonia and dementia: implementation of a practice guideline
152. Advance care planning for nursing home residents with dementia: Influence of “we DECide” on policy and practice
153. The Effects of Advance Care Planning Interventions on Nursing Home Residents: A Systematic Review
154. A review of the implementation and research strategies of advance care planning in nursing homes
155. Perceived needs for support among care home staff providing end of life care for people with dementia: a qualitative study
156. Education and training to enhance end-of-life care for nursing home staff: A systematic literature review
157. Root Cause Analyses of Transfers of Skilled Nursing Facility Patients to Acute Hospitals: Lessons Learned for Reducing Unnecessary Hospitalizations
158. Pragmatic cluster randomised controlled trial of facilitated family case conferencing compared with usual care for improving end of life care and outcomes in nursing home residents with advanced dementia and their families: The IDEAL study protocol Pallia
159. A model for implementing guidelines for person-centered care in a nursing home setting
160. Study protocol for ‘we DECide’: Implementation of advance care planning for nursing home residents with dementia
161. Consensus-Derived Interventions to Reduce Acute Care Transfer (INTERACT)-Compatible Order Sets for Common Conditions Associated with Potentially Avoidable Hospitalizations
162. Developing palliative care practice guidelines and standards for nursing home-based palliative care teams: A delphi study
163. A systematic review of interventions to change staff care practices in order to improve resident outcomes in nursing homes
164. The optimizing patient transfers, impacting medical quality, and improving symptoms: Transforming institutional care approach: preliminary data from the implementation of a centers for medicare and medicaid services nursing facility demonstration project
165. Implementing an advance care planning program in german nursing homes
166. A Critical Analysis and Adaptation of a Clinical Practice Guideline for the Management of Behavioral Problems in Residents with Dementia in Long-Term Care
167. Leadership collaborative education intervention to enhance the quality of end-of-life care in nursing homes: The IMPRESS project
168. Systematic Review of Interdisciplinary Interventions in Nursing Homes
169. Quality of advance care planning policy and practice in residential aged care facilities in Australia
170. Barriers to providing end-of-life care for people with dementia: A whole-system qualitative study
171. Implementation of physician orders for life sustaining treatment in nursing homes in california: Evaluation of a novel statewide dissemination mechanism
172. A systematic review of staff training interventions to reduce the behavioural and psychological symptoms of dementia
173. Predicting nursing home adherence to a clinical trial intervention: Lessons for the conduct of cluster randomized trials
174. The effect of policy on end-of-life care practice within nursing care homes: A systematic reviewEnd-of-life care pathways for improving outcomes in caring for the dying
175. Reducing Potentially Preventable Hospital Transfers: Results from a Thirty Nursing Home Collaborative
176. Impact of a multidisciplinary intervention on antibiotic use for nursing homeAcquired Pneumonia
177. Physicians’ Attitudes Toward Guidelines for the Treatment of Hospitalized Nursing Home-Acquired Pneumonia
178. A residential aged care end-of-life care pathway (RAC EoLCP) for Australian aged care facilities
179. A Multifaceted Intervention to Implement Guidelines Did Not Affect Hospitalization Rates for Nursing Home-Acquired Pneumonia
180. End-of-life care pathways for improving outcomes in caring for the dying
181. Implementing a quality improvement programme in palliative care in care homes: A qualitative study
182. A complex regional intervention to implement advance care planning in one town’s nursing homes: Protocol of a controlled inter-regional study
183. The essentials of Advance Care Planning for end-of-life care for older people
184. Reducing hospitalizations from long-term care settings
185. Barriers to and facilitators of clinical practice guideline use in nursing homes
186. Development and pilot testing of computerized order entry algorithms for geriatric problems in nursing homes
187. Improving end-of-life outcomes in nursing homes by targeting residents at high-risk of mortality for palliative care: Program description and evaluation
188. Improving care for nursing home-acquired pneumonia in a managed care environment
189. Pneumonia care and the nursing home: A qualitative descriptive study of resident and family member perspectives
190. The Application of Evidence-Based Principles of Care in Older Persons (Issue 4): Pain Management
191. A multifaceted intervention to implement guidelines improved treatment of nursing home-acquired pneumonia in a State Veterans Home
192. Effect of a clinical pathway to reduce hospitalizations in nursing home residents with pneumonia: A randomized controlled trial
193. Effect of increasing the intensity of implementing pneumonia guidelines: A randomized, controlled trial
194. Not eligible (dutch only) How can nursing homes make use of the guideline: “Prevention of fall incidents in the elderly” by the Dutch Institute for Healthcare Improvement (CBO)?
195. Not eligible (french only) A Clinical Pathway for Treating Pneumonia in the Nursing Home: Part II: The Administrators’ Perspective and How It Differs From Nurses’ Views
196. No article found (missing) Promoting communication and documentation of advance care planning in long-term care facilities.
197. https://lifeintheslowerlane.com/2025/05/20/a-quality-improvement-intervention-to-increase-palliative-care-in-nursing-homes/
198. Antibiotic use, hospital admissions, and mortality before and after implementing guidelines for nursing home-acquired pneumonia
199. Nursing home – Acquired pneumonia
200. Behavior problems in demented nursing home residents: A multifaceted approach to assessment and management
201. Treatment Decisions for Infections Occurring in Nursing Home Residents
202. Policy without technology: A barrier to improving nursing home care
203. Treatment of an Influenza A Outbreak in a Teaching Nursing Home: Effectiveness of a Protocol for Prevention and Control
204. Models for delivery and co-ordination of primary or secondary health care (or both) to older adults living in aged care facilities
205. Facilitators and barriers to advance care planning implementation in Australian aged care settings: A systematic review and thematic analysis
206. A meta-synthesis of factors influencing nursing home staff decisions to transfer residents to hospital
207. A quantitative systematic review of the effects of training interventions on enhancing the competence of nursing staff in managing challenging patient behaviour