The implementation and impacts of national standards for comprehensive care in acute care hospitals: An integrative review.
Beibei Xiong, Christine Stirling, Melinda Martin-Khan
PMID 38020841WHAT IT FOUND
Only Australia, Norway and the UK were found to have national comprehensive-care standards in acute hospitals.
Evidence on patient outcomes was sparse: one Australian study reported higher standard adherence and a gradual delirium-rate decrease.
Key findings
01The review included 16 articles and identified only Australia, Norway and the UK as having national standards for comprehensive care in acute care hospitals.
02Developing a comprehensive care plan was the most challenging implementation issue for the Australian standard, because no standard care plan was used by all disciplines and multidisciplinary care planning was difficult.
03Only one peer-reviewed paper examined outcomes of the Australian standard, and no publications were identified that examined explicit outcomes of the Norwegian or British standards.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 16 articles were included, and only three countries were identified as having national standards for comprehensive care in acute hospitals. The review included mostly non-research evidence, and studies were not excluded based on quality appraisal. Methods across included studies were too diverse to pool quantitative data. Only one peer-reviewed paper examined outcomes of the Australian standard, and none examined outcomes of the Norwegian or British standards. Two papers were excluded because they could not be translated in time, and other publications may have been missed because of different terminology. Full texts not available or not in English or Chinese were excluded.
Declared interests
National Health and Medical Research Council of the Australian Government funded the project, and one author was supported by a University of Queensland graduate scholarship. The authors declared no conflict of interest and said the funder did not design, implement or analyse the research.
The easy way to misread this
Do not read this as proof that comprehensive-care standards improve patient outcomes. The review found only one Australian study examining outcomes, and no studies examining outcomes of Norwegian or British standards.