Strengthening Geriatric Expertise in Swiss Nursing Homes: INTERCARE Implementation Study Protocol.
Aged
Clinical Competence
/ standards
Cross-Over Studies
Geriatrics
/ education
Homes for the Aged
/ standards
Humans
Leadership
Models, Nursing
Non-Randomized Controlled Trials as Topic
Nursing Homes
/ standards
Practice Patterns, Nurses'
/ organization & administration
Quality of Health Care
Switzerland
clinical leadership
hospitalization
implementation science
interprofessional models of care
nurse expert
nursing home
quality of care
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
23
03
2019
revised:
15
06
2019
accepted:
22
06
2019
pubmed:
19
7
2019
medline:
26
5
2020
entrez:
19
7
2019
Statut:
ppublish
Résumé
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. 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). NHs in the German-speaking region of Switzerland. 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. 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. 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. 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 67:2145-2150, 2019.
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2145-2150Subventions
Organisme : Nursing Science Foundation Switzerland
Pays : International
Organisme : Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
ID : 407440_167458
Pays : International
Informations de copyright
© 2019 The American Geriatrics Society.
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