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Table 1 Characteristics of included studies

From: Implementing guidelines in nursing homes: a systematic review

Study, nationality and design Participating providers (Level of training) Participating residents (Clusters, number) Outcome (relevant for this systematic review) Outcome measurement Outcome measurement frequency/period Length of post-intervention follow-up
De Visschere et al. (2012) [31], Belgium.
Cluster-randomised controlled trial.
Nurses, nurse aids. Level of training not stated. 12 nursing homes (N = 297).
Nursing home residents, mean age 84 years, high degree of physical disability and cognitive impairment.
Patient outcome: oral hygiene level of the participating residents: dental plaque, denture plaque, tongue plaque (primary outcomes). Dental plaque: Silnes and Löe plaque index. Denture plaque: Augsburger and Elahi Methylene-blue test. Tongue plaque: Winkel tongue coating index. Tests carried out by trained external examiners. Measured once after the 6 months intervention period. -
Köpke et al. (2012) [32], Germany.
Cluster-randomised controlled trial.
Nurses with three years of vocational training, certified nurse assistants with 1 year vocational training, untrained nurse assistants. 36 nursing homes (N = 3670).
Nursing home residents, mean age 85.5 years, high degree of physical disability and cognitive impairment.
Professional practice: the number of residents with physical restraints after 6 months (primary outcome). Restraint use at 3 months (secondary outcome). Unannounced observation by blinded investigators on three different occasions during one day. Measured after 3 and 6 months during the 6 months intervention period. -
Tjia et al. (2015) [36], USA.
Cluster-randomised controlled trial.
Nurses, certified nurse assistants, physicians, nursing home leaders. Level of training not stated. 42 nursing homes (N = unknown). Professional practice:
Facility-level change in atypical antipsychotic prescribing rates (primary outcome).
Screening of pharmacy dispensing data. Not stated who assessed the data. Measured monthly during the 12 months intervention period. -
Van Gaal (2011a/b) [33, 34], Netherlands.
Cluster-randomised controlled trial.
Nurses. Level of training not stated. 10 wards from 6 nursing homes (N = 392).
Nursing home residents, mean age 78 years, half of them physically impaired. No cognitive impairment.
Patient outcome (Part I): Incidence of adverse events: pressure ulcer, urinary tract infections and falls (primary outcome).
Professional practice (Part II): adequate care given to nursing home residents at risk of adverse events (secondary outcome).
Primary outcome: chart review and inspection of patient’s skin by independent research assistants.
Secondary outcome: chart review and patient observation by independent research assistants.
Primary outcomes: measured weekly during post-intervention follow up.
Secondary outcomes: measured weekly during post-intervention follow-up. Three additional observational visits on every ward. No measurement during the 14 months intervention period.
9 months.
Ward et al. (2010) [35], Australia.
Cluster-randomised controlled trial.
Nursing home staff including physicians. Level of training not stated. 88 nursing homes (N = 5391).
Nursing home residents, mean age 85.5 years, about 70 % able to stand or walk with or without assistance, 21 % received dementia-specific care.
Professional practice: use of vitamin D supplements, use of hip protectors (primary outcomes).
Patient outcome: change in fall rates, residents with a fractured neck of femur (primary outcomes).
Chart review by nursing home staff. Monthly during the 17 months intervention period. -