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The State of Evidence-Based Care in Long-Term Care Institutions: A Provincial Survey*

Published online by Cambridge University Press:  29 November 2010

Julie Richardson
Affiliation:
St. Peter's Hospital
Julie Moreland
Affiliation:
McMaster University
Pat Fox
Affiliation:
McMaster University

Abstract

A provincial survey was undertaken in Ontario, Canada concerning the prevalence of the use of practice guidelines in chronic care and long-term care facilities and the opinions of staff about the clinical conditions or problems important for developing clinical practice guidelines and the factors that promote change in clinical practice. Five hundred and fifty surveys were sent out and 306 returned from two mailings. Forty per cent of the facilities were aware of evidence-based guidelines while only 21.6 per cent were using them. They were being used most in government-funded agencies, then in acute care facilities with chronic care beds and nursing homes and least in non-government funded agencies. The clinical problems which agencies felt were important for guideline development were behavioural problems, continence, feeding problems and problems with skin care. The results of this survey have implications for funding of these institutions as well as for identifying the situations where evidence is needed for future care and where it is presently available but not being utilized and understanding the reasons for this approach to practice.

Résumé

En Ontario (Canada), on a mené une enquête sur l'importance du recours aux directives cliniques dans les établissements de maladies chroniques et de soins de longue durée et de la prise en compte de l'opinion du personnel en matière de conditions cliniques ou de problèmes reliés au développement des directives de pratique clinique et sur les facteurs qui initient les changements de la pratique clinique. Cinq cent cinquante questionnaires ont été envoyés en deux étapes et 306 d'entre eux ont été retournés. Quarante pour cent des établissements connaissaient les directives fondées sur les résultats mais seulement 21,6 pour cent les utilisaient. Elles sont surtout utilisées par les organismes financés par le gouvernement, plus par les établissements de soins aigus qui disposent de lits pour les malades chroniques et par les centres d'accueil et moins par les organismes qui ne sont pas financés par le gouvernement. Les problèmes cliniques que les organismes jugent les plus importants pour l'élaboration des directives sont les problèmes de comportement, l'incontinence, les problèmes d'alimentation et les problèmes de soins de la peau. Les conclusions du sondage pourront servir à fixer le financement des établissements et à déterminer les cas où il faudra fonder les soins sur les résultats et ceux où l'on dispose de résultats sur lesquels constituer les soins sans toutefois s'y fier et pour comprendre les raisons de cette approche.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2001

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