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Strengthening Geriatric Expertise in Swiss Nursing Homes: Intercare Implementation Study Protocol

Zuniga, Franziska and De Geest, Sabina and Guerbaai, Raphaelle Ashley and Basinska, Kornelia and Nicca, Dunja and Kressig, Reto W. and Zeller, Andreas and Wellens, Nathalie I. H. and De Pietro, Carlo and Vlaeyen, Ellen and Desmedt, Mario and Serdaly, Christine and Simon, Michael. (2019) Strengthening Geriatric Expertise in Swiss Nursing Homes: Intercare Implementation Study Protocol. Journal of the American Geriatrics Society, 67 (10). pp. 2145-2150.

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Abstract

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.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Institut für Pflegewissenschaft
UniBasel Contributors:Zuniga, Franziska and De Geest, Sabina M. and Guerbaai, Raphaelle Ashley and Basinska, Kornelia and Nicca, Dunja and Simon, Michael
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Wiley
ISSN:0002-8614
e-ISSN:1532-5415
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:27 Nov 2019 09:35
Deposited On:27 Nov 2019 09:35

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