Expanded nursing competencies to improve person-centred care for nursing home residents with complex health needs (Expand-Care) : study protocol for an exploratory cluster-randomised trial
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
INTRODUCTION: Older age is associated with multimorbidity, chronic diseases and acute deteriorations and leads to complex care needs. Nursing home residents are more often unnecessarily transferred to emergency departments or hospitals than community dwellers-largely due to a lack of qualified staff and diffusion of responsibility in the institutions. In Germany, only few academically trained nurses work in nursing homes, and their potential roles are unclear. Therefore, we aim to explore feasibility and potential effects of a newly defined role profile for nurses with bachelors' degree or equivalent qualification in nursing homes.
METHODS AND ANALYSIS: A pilot study (Expand-Care) with a cluster-randomised controlled design will be conducted in 11 nursing homes (cluster) in Germany, with an allocation ratio of 5:6 to the intervention or control group, aiming to include 15 residents per cluster (165 participants in total). Nurses in the intervention group will receive training to perform role-related tasks such as case reviews and complex geriatric assessments. We will collect data at three time points (t0 baseline, t1 3 months and t2 6 months after randomisation). We will measure on residents' level: hospital admissions, further health services use and quality of life; clinical outcomes (eg, symptom burden), physical functioning and delivery of care; mortality, adverse clinical incidents and changes in care level. On nurses' level, we will measure perception of the new role profile, competencies and implementation of role-related tasks as part of the process evaluation (mixed methods). An economic evaluation will explore resource use on residents' (healthcare utilisation) and on nurses' level (costs and time expenditure).
ETHICS AND DISSEMINATION: The ethics committees of the University of Lübeck (Nr. 22-162) and the University Clinic Hamburg-Eppendorf (Nr. 2022-200452-BO-bet) approved the Expand-Care study. Informed consent is a prerequisite for participation. Study results will be published in open-access, peer-reviewed journals and reported at conferences and in local healthcare providers' networks.
TRIAL REGISTRATION NUMBER: DRKS00028708.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
BMJ open - 13(2023), 7 vom: 11. Juli, Seite e072955 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Silies, Katharina Theodora [VerfasserIn] |
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| Links: |
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| Themen: |
Aged |
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| Anmerkungen: |
Date Completed 13.07.2023 Date Revised 18.07.2023 published: Electronic DRKS: DRKS00028708 Citation Status MEDLINE |
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| doi: |
10.1136/bmjopen-2023-072955 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM359345875 |
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| 245 | 1 | 0 | |a Expanded nursing competencies to improve person-centred care for nursing home residents with complex health needs (Expand-Care) |b study protocol for an exploratory cluster-randomised trial |
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| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a INTRODUCTION: Older age is associated with multimorbidity, chronic diseases and acute deteriorations and leads to complex care needs. Nursing home residents are more often unnecessarily transferred to emergency departments or hospitals than community dwellers-largely due to a lack of qualified staff and diffusion of responsibility in the institutions. In Germany, only few academically trained nurses work in nursing homes, and their potential roles are unclear. Therefore, we aim to explore feasibility and potential effects of a newly defined role profile for nurses with bachelors' degree or equivalent qualification in nursing homes | ||
| 520 | |a METHODS AND ANALYSIS: A pilot study (Expand-Care) with a cluster-randomised controlled design will be conducted in 11 nursing homes (cluster) in Germany, with an allocation ratio of 5:6 to the intervention or control group, aiming to include 15 residents per cluster (165 participants in total). Nurses in the intervention group will receive training to perform role-related tasks such as case reviews and complex geriatric assessments. We will collect data at three time points (t0 baseline, t1 3 months and t2 6 months after randomisation). We will measure on residents' level: hospital admissions, further health services use and quality of life; clinical outcomes (eg, symptom burden), physical functioning and delivery of care; mortality, adverse clinical incidents and changes in care level. On nurses' level, we will measure perception of the new role profile, competencies and implementation of role-related tasks as part of the process evaluation (mixed methods). An economic evaluation will explore resource use on residents' (healthcare utilisation) and on nurses' level (costs and time expenditure) | ||
| 520 | |a ETHICS AND DISSEMINATION: The ethics committees of the University of Lübeck (Nr. 22-162) and the University Clinic Hamburg-Eppendorf (Nr. 2022-200452-BO-bet) approved the Expand-Care study. Informed consent is a prerequisite for participation. Study results will be published in open-access, peer-reviewed journals and reported at conferences and in local healthcare providers' networks | ||
| 520 | |a TRIAL REGISTRATION NUMBER: DRKS00028708 | ||
| 650 | 4 | |a Clinical Trial Protocol | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Aged | |
| 650 | 4 | |a Health Services for the Aged | |
| 650 | 4 | |a Patient-Centered Care | |
| 650 | 4 | |a Quality of Life | |
| 700 | 1 | |a Vonthein, Reinhard |e verfasserin |4 aut | |
| 700 | 1 | |a Pohontsch, Nadine Janis |e verfasserin |4 aut | |
| 700 | 1 | |a Huckle, Tilman Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Sill, Janna |e verfasserin |4 aut | |
| 700 | 1 | |a Olbrich, Denise |e verfasserin |4 aut | |
| 700 | 1 | |a Inkrot, Simone |e verfasserin |4 aut | |
| 700 | 1 | |a Frielitz, Fabian-Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Lühmann, Dagmar |e verfasserin |4 aut | |
| 700 | 1 | |a Scherer, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a König, Inke |e verfasserin |4 aut | |
| 700 | 1 | |a Balzer, Katrin |e verfasserin |4 aut | |
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