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Aim: To investigate barriers to healthcare professionals recognizing and managing delirium in hospitalized older people. Design: A mixed‐methods systematic review. PROSPERO ID: CRD42020187932. Data Sources: MEDLINE, EMBASE, PsycINFO and CINAHL were searched (2007 to February 2023). Review Methods: Included studies focused on healthcare professionals' recognition and management of delirium for patients aged 65 years and over in a hospital ward or emergency department. Enhancing rigour, screening of results was conducted independently by two researchers. Qualitative and quantitative data were tabulated separately and grouped. Data were compared to identify similarities and differences. All studies were quality appraised. Results: 43 studies were included; 24 quantitative, 16 qualitative and three mixed‐methods. Data synthesis highlighted synergy between qualitative and quantitative findings. Barriers were reflected in six themes: (1) healthcare professionals' knowledge and understanding; (2) communication; (3) workforce development; (4) interprofessional working; (5) confounders; and (6) organizational constraints. Conclusions: Of significance, for older adults in hospital experiencing delirium, there is variability in whether and how well it is recognized and managed. To prevent adverse outcomes best practice guidance for screening, recognizing, diagnosing and managing delirium in older people needs to be agreed and disseminated widely. Supporting healthcare professionals to care for this patient population using an integrated approach is essential, how to involve and communicate with patients and their family and friends, how to recognize and manage delirium for patients with additional needs, e.g., those living with dementia and/or a learning disability. Hospitals need to have policy and guidance in place for the recognition and management of delirium in older adults presenting to a ward or to an emergency department. An IT infrastructure is needed that integrates assessments and care management plans in patient electronic records and makes them accessible within and across teams in hospital, primary and community care settings. Patient or Public Contribution: There was no patient or public contribution to this systematic review. Implications for the Profession and Patient Care: Healthcare professionals can be better supported to be able to recognize and manage delirium during an acute hospital stay for older adults. This includes maximizing best care for those patients living with dementia, involving families and friends to help understand patients' baseline status and changes and supporting families and friends during this process. Of significance, attention to hospital IT infrastructures is warranted, integrating screening, assessment and care management plans in patients' electronic records and making these accessible to healthcare professionals caring for this patient population across care settings. Impact: What problem did the study address? Delirium is a common condition experienced by older hospitalized patients, but it is consistently under‐recognized which has implications for patient and organization outcomes. To help address this, understanding barriers to healthcare professionals recognizing and managing delirium for this patient population is paramount. What were the main findings? Barriers to healthcare professionals recognizing and managing delirium for this patient population were synthesized in six themes: (1) healthcare professionals' knowledge and understanding, (2) communication; (3) workforce development; (4) interprofessional working; (5) confounders; and (6) organizational constraints. Where and on whom will the research have an impact? The findings of this original systematic review can contribute to hospital policy and protocol for the recognition and management of delirium in older patients. The findings can meaningfully contribute to workforce professional development for practitioners caring for older people during an acute hospital stay and for practitioners in primary and community settings involved in the follow‐up of patients post hospital discharge. For researchers, the findings indicate several research recommendations including investigating the impact of an education programme for nurses and other healthcare professionals on the recognition and management of the condition and understanding and investigating how best to support delirium‐related distress experienced by patients and their families and practitioners. Reporting Method: This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (Page et al., 2021). [ABSTRACT FROM AUTHOR]

This paper discusses the sensitivity of instruments used to measure knowledge and attitudes toward older people. Existing standardized measurement instruments are reviewed, including a detailed examination of Palmore's Facts on Ageing Quiz (FAQ). A recent study conducted by the research team into the knowledge and attitudes of support workers (n = 155) employed in care homes for older people, which utilized the FAQ is described. Despite ongoing attempts to address the challenge of measuring knowledge and attitudes toward older people, previous literature reviews and the results of the recent support workers study have revealed inadequacies, confusion, contradictions, and a need for further research into this area. Further development and refinement of measures remain a key challenge for researchers working in this field. Service users (in this case, older people) will need to be actively involved in this process. If the reliability, validity, sensitivity, and specificity of existing instruments cannot, however, be further tested and established, then new instruments may need to be developed.

Background: A skilled, knowledgeable, and compassionate nurse workforce is pivotal to caring well for older people living in care homes. This requires the provision of continuing professional development and career planning for nurses, which are key also for nurse recruitment and retention. Continuing professional development and career planning strategies and interventions should be evidence‐driven. Objective: To identify the extent, range and nature of contemporary evidence regarding professional development and career planning for nurses caring for older people living in care homes. Methods: The methodological framework used was the Joanna Briggs Institute guidance for scoping reviews. The PRISMA extension for scoping reviews was used as the reporting framework. Four databases were searched from January 2010 to July 2021. Results were screened independently by two reviewers using eligibility criteria. Full texts and the reference lists of eligible articles were reviewed. Data were extracted for key elements from the 25 articles included. Results: Of the 25 articles, the majority were authored in the United States (n = 10) and UK (n = 8) with the remaining from Australia (n = 3), Canada (n = 3) and the Netherlands (n = 1). Four articles reported on professional development programmes. Three literature reviews addressed challenges for nurse participation in professional development, experiences of care home nurses as clinical leaders and managers, and leadership. Two expert commentaries reported on the challenges related to professional development and career planning for care home nurses. Sixteen empirical studies investigated a range of topics including: competencies, roles, intention to stay and leave, continuing professional development, and leadership. Key emergent factors that support professional development and career planning were as follows: access to structured learning opportunities addressing knowledge and skills specific to nursing frail older adults, a supportive working environment including adequate staffing, study time and flexible working, and integration of leadership development. Conclusions and implications for practice: This scoping review has highlighted factors that support and challenge professional development and career planning for nurses working in the care home sector. There remain important gaps in the opportunities for professional development and career planning for care home nurses that warrant attention. [ABSTRACT FROM AUTHOR]

Introduction There is a developing body of research about minority ethnic elders in the UK (Blakemore 2000, Gerrish 2000) but few empirical studies have focused on those who live in [...]

The article presents the 'five things about me' quality improvement project to contribute to person-centred care for older people on medical wards in Great Britain through the development of patient profiles. Other topics include the project's implementation by the Manchester Royal Infirmary in England, and the benefits of the project like improving mood and memory, bolstering pride in achievements, and strengthening relationships with care staff.