Search

Clinical practice guideline (CPG) recommendations for the management of challenging behaviours after traumatic brain injury (TBI) in hospital and inpatient rehabilitation settings are sparse. This systematic review aims to identify and appraise CPGs, and report high-quality recommendations for challenging behaviours after TBI in hospital and rehabilitation settings. A three-step search strategy was conducted to identify CPGs that met inclusion criteria. Two reviewers independently scored the AGREE II domains. Guideline quality was assessed based on CPGs adequately addressing four out of the six AGREE II domains. Data extraction was performed with a compilation of high-quality CPG recommendations. Seven CPGs out of 408 identified records met the inclusion criteria. Two CPGs were deemed high-quality. High-quality CPG recommendations with the strongest supporting evidence include behaviour management plans; beta-blockers for the treatment of aggression; selective serotonin reuptake inhibitors for moderate agitation; adamantanes for impaired arousal/attention in agitation; specialised, multi-disciplinary TBI behaviour management services. This systematic review identified and appraised the quality of CPGs relating to the management of challenging behaviours after TBI in acute hospital and rehabilitation settings. Further research to rigorously evaluate TBI behaviour management programs, investigation of evidence-practice gaps, and implementation strategies for adopting CPG recommendations into practice is needed. Two clinical practice guidelines appraised as high-quality outline recommendations for the management of challenging behaviours after traumatic brain injury in hospital and inpatient rehabilitation settings. High-quality guideline recommendations with the strongest supporting evidence for non-pharmacological treatment include behaviour management plans considering precipitating factors, antecedents, and reinforcing events. High-quality guideline recommendations with the strongest supporting evidence for pharmacological management include beta blockers for aggression in traumatic brain injury. Few guidelines provide comprehensive detail on the implementation of recommendations into clinical care which may limit adoption [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore and compare staff perceived challenges and facilitators in supporting resident self‐determination in ethno‐specific and mainstream nursing homes. Background: Staff and residents in ethno‐specific and mainstream nursing homes in most developed countries have shown increased cultural and linguistic diversity. This socio‐demographic change poses significant challenges for staff to support resident self‐determination of their own care. In‐depth understanding of those challenges in the two types of nursing homes is much needed to inform practice in nurse‐led nursing home care settings. Method: A qualitative description approach with thematic analysis was used in the study. Data were collected through five focus groups with 29 various direct care workers from two ethno‐specific nursing homes and a mainstream nursing home in Australia between March–September 2020. The study report followed the COREQ checklist. Results: Four themes were identified from focus group data. First, participants perceived communication challenges in identifying residents' preferences, especially in ethno‐specific nursing homes. Second, team efforts that included residents and their family members were highly valued as a way to meet residents' preferences. Third, participants described various levels of staff engagement in residents' care planning. In addition, staff in ethno‐specific nursing homes possessed richer resources to maintain meaningful relationships for residents compared with their counterparts in the mainstream nursing home. Conclusions: Staff in ethno‐specific nursing homes experience more challenges in supporting resident self‐determination but have richer resources to develop culturally safe and culturally competent care compared with their counterparts in the mainstream nursing home. Relevance to clinical practice: Findings provide new insights into challenges and practical solutions in supporting residents to self‐determine their own care in cross‐cultural aged care. Patient or Public Contribution: This study was co‐designed with three aged care organisations who funded the study. Staff employed by these organisations participated in the study. [ABSTRACT FROM AUTHOR]

Reviews literature on processes in conference planning and evaluation and reflects on the roles and tasks of facilitators at the thirtieth conference of the Australian Association of Adult and Community Education. (SK)