Evaluation of the Impact of a Paramedical Training Program for Nurses and Nursing Assistants on the Length of Stay and Prevention of Hospital Iatrogenic Complications in Elderly Patients (CORRESPAGE)

July 6, 2023 updated by: Hospices Civils de Lyon
In France, hospitalised elderly patients (EP) aged >75 years are expected to represent 1/3 of patients by 2030 (22% in 2015). In acute care wards outside geriatrics, the average length of stay increases with age, i.e. 8.5 days after the age of 90 compared with 5.5 days for younger patients. Dependence related to hospitalisation, partly avoidable, occurs in 30 to 60% of patients aged over 70. Faced with this situation Geriatric Mobile Teams (GMT) were created in 2002 to meet the need for geriatric expertise in hospitals and in the community by making punctual evaluations. Expert and multidisciplinary, the GMTs are a referring team for "advice, information and training for health care teams" for the care of vulnerable EPs. The GMTs are dependent on an exclusively medical demand system. The lack of knowledge of a specific care for EPs by nurses and nursing assistants and the occasional contribution of GMTs prevents a systematic targeted a for EP. Over the past 30 years, an American nursing programme (NICHE) aimed at improving the overall care of EPs in hospitals has shown that the training of geriatric resource nurses in speciality wards brought about a significant change in hospital geriatric culture. The training is based on evidence based practice including the HELP programme targeting confusion. The HELP programme has shown that nurses and nursing assistants play a pivotal role in reducing the incidence of hospital confusion. In the USA, the implementation of NICHE begins with the creation of a team of nursing leaders (geriatric/education/clinical care experts), dedicated to the coordination of the training and the companionship of geriatric resource nurses. Within the framework of the targets of the Ségur de la santé 2020 and Ma Santé 2022, our hypothesis is that an adaptation of NICHE to the French health context could improve specific care for EP in specialist wards, reduce the occurrence of complications and reduce the length of stay. Indeed, the GMT would ensure this coordination role in the training and support of a nurse and nursing assistant duo, based on the model of hygiene correspondents, in order to disseminate good geriatric practices.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

2671

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • France
      • Bourg en Bresse, France, 01012
        • Recruiting
        • Centre Hospitalier de Bourg en Bresse
        • Contact:
      • Lyon, France, 69004
        • Recruiting
        • Croix Rousse Hospital
      • Metz-Tessy, France, 74370
      • Pierre-Bénite, France, 69495
        • Recruiting
        • service de court séjour gériatrique, Hôpital Lyon Sud
        • Contact:
      • Villefranche-sur-Saône, France
        • Not yet recruiting
        • Hôpital Nord-Ouest
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

This study covers patients aged 75 and over hospitalised in participating specialitist wards (excluding geriatrics) (medicine, rheumatology, neurology, pneumology, orthopaedic surgery, digestive surgery, ENT and facial surgery)

Description

Inclusion Criteria:

  • Patients aged 75 years and over hospitalised in a participating specialtist wards
  • not objecting to the study,
  • including those under guardianship or curatorship.

Exclusion Criteria:

  • Patient not affiliated to a social security scheme
  • Patient at the end of life

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Post-intervention group (Training course group)
The experimental group will be composed of patients aged 75 and over hospitalised in specialised departments after the establishment of geriatric correspondents trained in the specific care for the elderly.
Other: Training of nurses and nursing assistants
Training of nurses and nursing assistants, based on the model of hygiene correspondents, in order to disseminate good geriatric practices
Pre-intervention group (Control group)
The control group will be composed of patients aged 75 years and over hospitalised in specialised departments before the introduction of geriatric correspondents trained in the specific care for the elderly. Their care will be conducted in accordance with usual practices.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Length of stay
Time Frame: The length of stay is calculated as the number of days between admission to the inclusion service and discharge documented in the medical record, assessed up to one month.
Length of stay compared between groups according to whether or not geriatric correspondents are in place. This criterion has the advantage of being easy to measure, robust and a reflection of overall care. It depends on the occurrence of complications that can be prevented by the intervention of paramedical staff.
The length of stay is calculated as the number of days between admission to the inclusion service and discharge documented in the medical record, assessed up to one month.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hospices Civils de Lyon

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2023

Primary Completion (Estimated)

July 1, 2027

Study Completion (Estimated)

July 1, 2027

Study Registration Dates

First Submitted

June 22, 2023

First Submitted That Met QC Criteria

July 6, 2023

First Posted (Actual)

July 7, 2023

Study Record Updates

Last Update Posted (Actual)

July 7, 2023

Last Update Submitted That Met QC Criteria

July 6, 2023

Last Verified

June 1, 2023

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 22-5125

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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