The state of evidence-based care in long-term care institutions: A provincial survey

A provincial survey was undertaken in Ontario, Canada concerning the preval ence of the use of practice guidelines in chronic care and long-term care f acilities and the opinions of staff about the clinical conditions or proble ms important for developing clinical practice guidelines and the factors th at promote change in clinical practice. Five hundred and fifty surveys were sent out and 306 returned from two mailings. Forty per cent of the facilit ies were aware of evidence-based guidelines while only 21.6 per cent were u sing them. They were being used most in govern rn ent-funded agencies, then in acute care facilities with chronic care beds and nursing homes and leas t in non-government funded agencies. The clinical problems which agencies f elt were important for guideline development were behavioural problems, con tinence, feeding problems and problems with skin care. The results of this survey have implications for funding of these institutions as well as for i dentifying the situations where evidence is needed for future care and wher e it is presently available but not being utilized and understanding the re asons for this approach to practice.