TY - JOUR
T1 - Unfinished care in residential aged care facilities
T2 - an integrative review
AU - Ludlow, Kristiana
AU - Churruca, Kate
AU - Mumford, Virginia
AU - Ellis, Louise A.
AU - Testa, Luke
AU - Long, Janet C.
AU - Braithwaite, Jeffrey
PY - 2021/4/3
Y1 - 2021/4/3
N2 - 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.
AB - 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.
KW - Analysis—systematic review
KW - Decision making
KW - Institutional care/residential care
KW - Nursing homes
KW - Workforce issues
KW - Long-term care
KW - Missed care
KW - Prioritization
UR - http://purl.org/au-research/grants/nhmrc/9100002
UR - http://www.scopus.com/inward/record.url?scp=85104048205&partnerID=8YFLogxK
U2 - 10.1093/geront/gnz145
DO - 10.1093/geront/gnz145
M3 - Review article
C2 - 31773131
VL - 61
SP - e61-e74
JO - Gerontologist
JF - Gerontologist
SN - 0016-9013
IS - 3
ER -