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Challenges in implementing an advance care planning programme in long-term care

Overview of attention for article published in Nursing Ethics, September 2016
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (55th percentile)
  • Good Attention Score compared to outputs of the same age and source (66th percentile)

Mentioned by

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5 tweeters

Citations

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36 Dimensions

Readers on

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190 Mendeley
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Title
Challenges in implementing an advance care planning programme in long-term care
Published in
Nursing Ethics, September 2016
DOI 10.1177/0969733016664969
Pubmed ID
Authors

Ciara McGlade, Edel Daly, Joan McCarthy, Nicola Cornally, Elizabeth Weathers, Rónán O’Caoimh, D William Molloy

Abstract

A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care. This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families. PARTICIPANTS AND RESEARCH CONTEXT: long-term-care residents in two nursing homes and one community hospital. The local research ethics committee granted ethical approval. Following implementation, over 50% of all residents had completed some form of end-of-life care plan. Of the 70 residents who died in the post-implementation period, 14% had no care plan, 10% (with capacity) completed an advance care directive and lacking such capacity, 76% had an end-of-life care plan completed for them by the medical team, following discussions with the resident (if able) and family. The considerable logistical challenge of releasing staff for training triggered development of an e-learning programme to facilitate training. The challenges encountered were largely concerned with preserving resident's autonomy, avoiding harm and suboptimal or crisis decision-making, and ensuring residents were treated fairly through optimisation of finite resources. Although it may be too late for many long-term-care residents to complete their own advance care directive, the 'Let Me Decide' programme includes a feasible and acceptable option for structured end-of-life care planning for residents with variable capacity to complete an advance care directive, involving discussion with the resident (to the extent they were able) and their family. While end-of-life care planning was time-consuming to deliver, nursing staff were willing to overcome this and take ownership of the programme, once the benefits in improved communication and enhanced peace of mind among all parties involved became apparent in practice.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 190 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 190 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 28 15%
Student > Bachelor 25 13%
Student > Postgraduate 18 9%
Student > Ph. D. Student 18 9%
Student > Doctoral Student 13 7%
Other 47 25%
Unknown 41 22%
Readers by discipline Count As %
Nursing and Health Professions 62 33%
Medicine and Dentistry 33 17%
Psychology 18 9%
Social Sciences 9 5%
Business, Management and Accounting 3 2%
Other 17 9%
Unknown 48 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 April 2020.
All research outputs
#9,571,880
of 17,362,547 outputs
Outputs from Nursing Ethics
#235
of 543 outputs
Outputs of similar age
#120,969
of 275,161 outputs
Outputs of similar age from Nursing Ethics
#3
of 6 outputs
Altmetric has tracked 17,362,547 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 543 research outputs from this source. They receive a mean Attention Score of 4.2. This one has gotten more attention than average, scoring higher than 56% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 275,161 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.
We're also able to compare this research output to 6 others from the same source and published within six weeks on either side of this one. This one has scored higher than 3 of them.