Nursing staff attitudes towards the prevention of adverse events among hospitalized people with dementia: Qualitative systematic review and evidence synthesis

Introduction: Negative attitudes among nursing staff are linked to adverse events in hospitalized people with dementia, but no qualitative synthesis has thoroughly explored this issue. Aim: To synthesize existing qualitative evidence regarding the attitudes of nursing staff towards the prevention of adverse events (AE) among hospitalized people with dementia. Methods: Literature searches were conducted across PubMed, CINAHL, APA PsycINFO, Web of Science, BVS, Scopus, Cochrane Library, and Google Scholar. All primary qualitative or mixed-methods studies with a qualitative component published in peer-reviewed journals in English, Portuguese, or Spanish were eligible. The search covered all records from each database's start date to July 21. Methodological quality was assessed using the JBI tool. A meta-aggregative approach extracted and synthesized evidence with JBI's SUMARI. Confidence was graded using ConQual. Results: Eight high-income country studies yielded 122 findings in 18 categories, resulting in four synthesized findings: (1) Perceptions related to the organizational barriers to the provision of safe nursing care for people with dementia; (2) Misconceptions, negative emotions, and perception of lack of preparedness among nursing staff relate to negative attitudes towards prevention AE; (3) Perception of supportive organizational strategies fosters positive attitudes towards prevention AE; (4) Personal and emotional attributes were linked with a positive predisposition towards taking responsibility for safety practices in this context. The confidence in the findings was low. Conclusion: These attitudes reflect organizational conditions and personal beliefs, emotions, and experiences, which influence care practices. Although more studies are needed, hospitals might benefit from fostering empathetic and proactive attitudes among staff to prevent adverse events.