Strengthening Geriatric Expertise in Swiss Nursing Homes: INTERCARE Implementation Study Protocol.
J Am Geriatr Soc
; 67(10): 2145-2150, 2019 10.
Article
em En
| MEDLINE
| ID: mdl-31317544
ABSTRACT
OBJECTIVES:
Nursing home (NH) residents with complex care needs ask for attentive monitoring of changes and appropriate in-house decision making. However, access to geriatric expertise is often limited with a lack of geriatricians, general practitioners, and/or nurses with advanced clinical skills, leading to potentially avoidable hospitalizations. This situation calls for the development, implementation, and evaluation of innovative, contextually adapted nurse-led care models that support NHs in improving their quality of care and reducing hospitalizations by investing in effective clinical leadership, geriatric expertise, and care coordination.DESIGN:
An effectiveness-implementation hybrid type 2 design to assess clinical outcomes of a nurse-led care model and a mixed-method approach to evaluate implementation outcomes will be applied. The model development, tailoring, and implementation are based on the Consolidated Framework for Implementation Research (CFIR).SETTING:
NHs in the German-speaking region of Switzerland.PARTICIPANTS:
Eleven NHs were recruited. The sample size was estimated assuming an average of .8 unplanned hospitalizations/1000 resident days and a reduction of 25% in NHs with the nurse-led care model. INTERVENTION The multilevel complex context-adapted intervention consists of six core elements (eg, specifically trained INTERCARE nurses or evidence-based tools like Identify, Situation, Background, Assessment and Recommendation [ISBAR]). Multilevel implementation strategies include leadership and INTERCARE nurse training and support. MEASUREMENTS The primary outcomes are unplanned hospitalizations/1000 care days. Secondary outcomes include unplanned emergency department visits, quality indicators (eg, physical restraint use), and costs. Implementation outcomes included, for example, fidelity to the model's core elements.CONCLUSION:
The INTERCARE study will provide evidence about the effectiveness of a nurse-led care model in the real-world setting and accompanying implementation strategies. J Am Geriatr Soc 672145-2150, 2019.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Competência Clínica
/
Padrões de Prática em Enfermagem
/
Instituição de Longa Permanência para Idosos
/
Casas de Saúde
Tipo de estudo:
Clinical_trials
/
Guideline
/
Prognostic_studies
Limite:
Aged
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Am Geriatr Soc
Ano de publicação:
2019
Tipo de documento:
Article