Table 4.
Strategies, outcomes, and overall risk of bias
| Author, year | Strategies | Outcomes | Overall Risk of Bias |
||
|---|---|---|---|---|---|
| Advance Care Planning |
Staff training and education |
Integrating a palliative team |
|||
| Agar et al, 2017 | X | X | Healthcare Use Enhance NH palliative care (+) Symptoms Assessment/Management Process: pain/discomfort (+), restlessness (+), agitation (+), constipation (+), skin issues (+), resistive to care (+),respiratory issues (+) Resident/surrogate report: Comfort (−) Quality of life Resident/surrogate ratings at the end-of-life (−) Family Evaluation of Care Satisfaction with care (−) |
Low | |
| Berkowitz et al, 2011 | X | X | X | Healthcare Use Reduce potentially burdensome care (+) Enhance NH palliative care (+) |
Unclear |
| Boogard et al., 2018 | X | Symptoms Resident/surrogate report: Comfort (−) Dying symptoms (+), physical distress (−), emotional distress (−), wellbeing (−) Family Evaluation of Care Satisfaction * |
High | ||
| Brännström et al, 2016 | X | Symptoms Resident/surrogate report: shortness of breath (+), nausea (+), pain (−), tiredness (−), drowsiness (−), loss of appetite (−), anxiety (−), depression (−), wellbeing (−) |
Unclear | ||
| Casarett et al, 2005 | X | Healthcare Use Reduce potentially burdensome care* Enhance NH palliative care* Family Evaluation of Care End-of-life care ratings (+) |
Low | ||
| Chapman and Toseland, 2007 | X | Symptoms Resident/surrogate report: pain (−), depression (−),agitation (−), physically nonaggressive behaviors (+) |
Unclear | ||
| Comart et al, 2012 | X | X | Healthcare Use Reduce potentially burdensome care* Enhance NH palliative care (−) Symptoms Resident/surrogate report: depression (+), delirium (−), falls (−), pain (−), skin ulcers (−), shortness of breath (−), weight loss (−) |
Unclear | |
| Hanson et al, 2005 | X | Healthcare Use Enhance NH palliative care (+) Symptoms Assessment/Management Process: pain* Resident/surrogate report: pain (−) Advance Care Planning Documented discussions and orders (+) Advance Directives (−) |
High | ||
| Hockley at al, 2010 | X | X | Healthcare Use Reduce potentially burdensome care (+) Enhance NH palliative care (+) Advance Care Planning Documented discussions and orders (+) |
Unclear | |
| Kinley et al, 2014 | X | Healthcare Use Reduce potentially burdensome care (−) Enhance NH palliative care (+) Advance Care Planning Documented discussions and orders (−) |
Low | ||
| Strumpf et al, 2004 | X | X | Healthcare Use Enhance NH palliative care (+) Symptoms Assessment/Management Process: pain (+) Advance Care Planning Advance Directives (+) |
Unclear | |
| Temkin-Greener et al, 2018 | X | X | Healthcare Use Reduce potentially burdensome care (−) Symptoms Resident/surrogate report: pain (−), depression (−) |
Low | |
| Teo et al, 2014 | X | X | X | Healthcare Use Reduce potentially burdensome care* Costs/Expenditures Reduce costs (+) |
Unclear |
NH= Nursing Home
*
= mixed results