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    Pilot cluster randomised trial of an evidence-based intervention to reduce avoidable hospital admissions in nursing home residents (Better Health in Residents of Care Homes with Nursing - BHiRCH-NH Study)

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    Publication date
    2020-12
    Author
    Sampson, E.L.
    Feast, A.
    Blighe, Alan
    Froggatt, K.
    Hunter, R.
    Marston, L.
    McCormack, B.
    Nurock, S.
    Panca, M.
    Powell, Catherine
    Rait, G.
    Robinson, L.
    Woodward-Carlton, Barbara
    Young, J.
    Downs, Murna G.
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    Keyword
    Evidence-based intervention
    Avoidable hospital admissions
    Nursing home residents
    Better Health in Residents of Care Homes with Nursing
    BHiRCH-NH study
    Rights
    (c) 2020 The Authors. This is an Open Access article distributed under a Creative Commons CC-BY license (https://creativecommons.org/licenses/by/4.0/)
    Peer-Reviewed
    Yes
    
    Metadata
    Show full item record
    Abstract
    Objectives To pilot a complex intervention to support healthcare and improve early detection and treatment for common health conditions experienced by nursing home (NH) residents. Design Pilot cluster randomised controlled trial. Setting 14 NHs (7 intervention, 7 control) in London and West Yorkshire. Participants NH residents, their family carers and staff. Intervention Complex intervention to support healthcare and improve early detection and treatment of urinary tract and respiratory infections, chronic heart failure and dehydration, comprising: (1) ‘Stop and Watch (S&W)’ early warning tool for changes in physical health, (2) condition-specific care pathway and (3) Situation, Background, Assessment and Recommendation tool to enhance communication with primary care. Implementation was supported by Practice Development Champions, a Practice Development Support Group and regular telephone coaching with external facilitators. Outcome measures Data on NH (quality ratings, size, ownership), residents, family carers and staff demographics during the month prior to intervention and subsequently, numbers of admissions, accident and emergency visits, and unscheduled general practitioner visits monthly for 6 months during intervention. We collected data on how the intervention was used, healthcare resource use and quality of life data for economic evaluation. We assessed recruitment and retention, and whether a full trial was warranted. Results We recruited 14 NHs, 148 staff, 95 family carers and 245 residents. We retained the majority of participants recruited (95%). 15% of residents had an unplanned hospital admission for one of the four study conditions. We were able to collect sufficient questionnaire data (all over 96% complete). No NH implemented intervention tools as planned. Only 16 S&W forms and 8 care pathways were completed. There was no evidence of harm. Conclusions Recruitment, retention and data collection processes were effective but the intervention not implemented. A full trial is not warranted.
    URI
    http://hdl.handle.net/10454/18260
    Version
    Published version
    Citation
    Sampson EL, Feast A, Blighe A et al (2020) Pilot cluster randomised trial of an evidence-based intervention to reduce avoidable hospital admissions in nursing home residents (Better Health in Residents of Care Homes with Nursing - BHiRCH-NH Study). BMJ Open. 10(12): e040732.
    Link to publisher’s version
    http://dx.doi.org/10.1136/bmjopen-2020-040732
    Type
    Article
    Collections
    Life Sciences Publications
    Health Studies Publications

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