A staff training and management intervention in VA long-term care: impact on feeding assistance care quality

Abstract

Efforts to translate efficacious interventions into long-term care practice have had limited success due to the lack of consideration of key translational intervention components. A multi-faceted intervention was implemented in two veteran affairs facilities to improve feeding assistance care. There were three study phases: baseline, intervention, and follow-up. During each phase, trained research staff conducted standardized observations of 12 meals/participant to assess feeding assistance care quality. The staff received three initial training sessions followed by six consecutive weeks of feedback sessions wherein the observation-based care process measures were shared with the staff. There were significant, but modest, improvements in mealtime feeding assistance care processes, and most of the improvements were maintained during follow-up. A multi-faceted intervention resulted in significant, but modest, improvements in mealtime feeding assistance care quality. Organizational (staff schedules, communication) and environmental (dining location) barriers were identified that interfered with improvement efforts.

Keywords: Community living centers; Feeding assistance; Intervention; Long-term care; Nutrition; Quality improvement; Staff training; Unintentional weight loss.

Figures

Fig 1

Study participant flow chart

Fig 2

Randomization and data collection timeline across all units in both sites