Evidence-based intervention to reduce avoidable hospital admissions in care home residents (the Better Health in Residents in Care Homes (BHiRCH) study): protocol for a pilot cluster randomised trial.
Aged
Cluster Analysis
Evidence-Based Medicine
Homes for the Aged
Humans
Multicenter Studies as Topic
Nursing Homes
Patient Admission
/ statistics & numerical data
Patient Transfer
/ statistics & numerical data
Pilot Projects
Quality of Health Care
Quality of Life
Randomized Controlled Trials as Topic
dementia
geriatric medicine
heart failure
primary care
respiratory infections
urinary tract infections
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
27 05 2019
27 05 2019
Historique:
entrez:
29
5
2019
pubmed:
28
5
2019
medline:
5
6
2020
Statut:
epublish
Résumé
Acute hospital admission is distressing for care home residents. Ambulatory care sensitive conditions, such as respiratory and urinary tract infections, are conditions that can cause unplanned hospital admission but may have been avoidable with timely detection and intervention in the community. The Better Health in Residents in Care Homes (BHiRCH) programme has feasibility tested and will pilot a multicomponent intervention to reduce these avoidable hospital admissions. The BHiRCH intervention comprises an early warning tool for noting changes in resident health, a care pathway (clinical guidance and decision support system) and a structured method for communicating with primary care, adapted for use in the care home. We use practice development champions to support implementation and embed changes in care. Cluster randomised pilot trial to test study procedures and indicate whether a further definitive trial is warranted. Fourteen care homes with nursing (nursing homes) will be randomly allocated to intervention (delivered at nursing home level) or control groups. Two nurses from each home become Practice Development Champions trained to implement the intervention, supported by a practice development support group. Data will be collected for 3 months preintervention, monthly during the 12-month intervention and 1 month after. Individual-level data includes resident, care partner and staff demographics, resident functional status, service use and quality of life (for health economic analysis) and the extent to which staff perceive the organisation supports person centred care. System-level data includes primary and secondary health services contacts (ie, general practitioner and hospital admissions). Process evaluation assesses intervention acceptability, feasibility, fidelity, ease of implementation in practice and study procedures (ie, consent and recruitment rates). Approved by Research Ethics Committee and the UK Health Research Authority. Findings will be disseminated via academic and policy conferences, peer-reviewed publications and social media (eg, Twitter). ISRCTN74109734; Pre-results.
Identifiants
pubmed: 31133585
pii: bmjopen-2018-026510
doi: 10.1136/bmjopen-2018-026510
pmc: PMC6538003
doi:
Banques de données
ISRCTN
['ISRCTN74109734']
Types de publication
Clinical Trial Protocol
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e026510Subventions
Organisme : Marie Curie
ID : MCCC-FCO-11-U
Pays : United Kingdom
Organisme : Department of Health
ID : RP-PG-0612-20010
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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