RESUMO
BACKGROUND: Quality improvement (QI) interventions are designed to resolve the recurring challenges of care for older individuals, such as working conditions for staff, roles of older individuals in their own care and their families, and relevant stakeholders. Therefore, there is a need to map the impacts of QI interventions in older adult care settings and further improve health and social care systems associated with older adults. OBJECTIVE: This review aims to compile and synthesize the best available evidence regarding the effectiveness of policy and practice QI interventions in older adult care. The secondary aim is to understand the care of older individuals and QI intervention-related experiences and perspectives of stakeholders, care providers, older individuals, and their families. METHODS: The mixed methods review will follow the standard methodology used by Joanna Briggs Institute. The published studies will be searched through CINAHL, MEDLINE, PsycINFO, ASSIA, and Web of Science, and the unpublished studies through Mednar, Trove, OCLC WorldCat, and Dissertations and Theses. This review included both qualitative and quantitative analyses of patients undergoing older adult care and any health and care professionals involved in the care delivery for older adults; a broad range of QI interventions, including assistive technologies, effects of training and education, improved reporting, safety programs, and medical devices; the experiences and perspectives of staff and patients; the context of older adult care setting; and a broad range of outcomes, including patient safety. The standard procedure for reporting, that is, PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, will be followed. RESULTS: A result-based convergent synthesis design will be used in which both quantitative and qualitative studies will be analyzed separately, and the results of both syntheses will be then integrated during a final (convergent) synthesis. The integration will compare the findings of quantitative and qualitative evidence using tables in light of the results of both syntheses. CONCLUSIONS: This comprehensive review is expected to reflect on the insights into some QI interventions and their impact, outline some common challenges of quality for older adult care, and benefit both the practical usefulness of care service activities and the society at large. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/56346.
RESUMO
Health Impact Assessment (HIA) is increasingly applied in many developed countries as a tool for advancing healthy public policy. This research was carried out to obtain a HIA situation report for Nigeria and to assess ways of enhancing the use of HIA to promote healthy public policy. Semi structured questionnaires were administered both online and by hand to health and nonhealth professionals in Nigeria. Inferential statistics was used in the analysis of the 510 responses that were received. Only 29% of the respondents had ever heard about HIA; similarly, only 19.3% of those who were aware of HIA had received any form of HIA training. However, 93.2% of respondents were convinced that HIA would be beneficial to the Nigerian health system. Using the approach of SWOT Analysis to discuss the findings, this research concludes that the time has now come, and the right conditions are in place, for the integration of Health Impact Assessment into public policy in Nigeria. Raising awareness and political commitment are the two major strategies to help drive this agenda forward.