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Nurse Practitioner Led Implementation of Team Huddles in Long-Term Care Homes

18 maggio 2022 aggiornato da: Katherine McGilton, Toronto Rehabilitation Institute

Nurse Practitioner Led Implementation of Team Huddles in Long-Term Care Homes During COVID-19

A pre-experimental design to conduct a process evaluation and to compare the outcomes after implementing team huddles for the intervention and control groups.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Staff working in long-term care (LTC) homes during COVID-19 frequently reported lack of communication, collaboration, and teamwork, all of which are associated with staff dissatisfaction, health concerns, perceived of lack of support and moral distress. The purpose of this study was to introduced regular huddles, led by a Nurse Practitioner, to support LTC staff during COVID-19. The objectives were to evaluate the process of huddle implementation and to examine differences between staff attending and not attending the huddles on outcomes of moral distress, job satisfaction, perceived support from the Nurse Practitioner, and health and mental health. Furthermore, we hypothesize that regular huddles can lead to improvements in resident-centred care and resident outcomes.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

42

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Canada
    • Ontario
      • Kitchener, Ontario, Canada, N2A 1Y5
        • Long-Term Care Home
      • Sarnia, Ontario, Canada
        • Long-Term Care Home

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Bambino
  • Adulto
  • Adulto più anziano

Accetta volontari sani

Sì

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • All staff working at the LTC home
  • All residents living in the home between January and December 2021

Exclusion Criteria:

  • N/A

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Altro
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Huddle attendees
Participants in this arm participated in huddles
Comportamentale: Team Huddles
Brief multidisciplinary meeting occurring twice a week for staff working at a LTC home led by a Nurse Practitioner. Huddles focused on discussing resident-care and staff-wellbeing.
Nessun intervento: Huddle non-attendees
Participants in this arm did not participate in huddles

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Overall morals distress and situations associated with COVID-19 in LTC settings contributing to moral distress were measured in the intervention and control arms using the Moral Distress in Dementia Care Instrument (Iaboni et al., 2021).
Lasso di tempo: 20 weeks
Moral Distress in Dementia Care is a ten-item checklist, where respondents are asked to rate moral distress associated with each item on a 5-point scale ranging from none (1) to an extremely large amount (5). Higher scores represent more moral distress.
20 weeks
Overall job satisfaction with current role was measured in the intervention and control arms using a single question asking, "How satisfied are you overall with your current job in the LTC home?" (Dolbier et al., 2005)
Lasso di tempo: 20 weeks
The single-item question was high reliability and validity (Dolbier et al., 2005) and has been used in previous studies in LTC homes (Schwendimann et al., 2016). Respondents rate job satisfaction on a 4-point scale ranging from strongly dissatisfied (1) to strongly satisfied (4), where higher scores indicate more satisfaction.
20 weeks
Overall health was measured in the intervention and control arms using a single question from Statistics Canada (2022) asking, "In general, how would you say your health is?"
Lasso di tempo: 20 weeks
Respondents rate their health on a 5-point scale ranging from poor (0) to excellent (4), where higher scores indicate better health.
20 weeks
Mental health was measured in the intervention and control arms using a single question from Statistics Canada (2022) asking, "In general, how would you say your mental health is?"
Lasso di tempo: 20 weeks
Respondents rate their mental health on a 5-point scale ranging from poor (0) to excellent (4), where higher scores indicate better mental health.
20 weeks
Perceived support from the nurse practitioner leading the huddles was measured in the intervention and control arms, assessed using the Supportive Supervisory Scale (McGilton 2010).
Lasso di tempo: 20 weeks
The 5-item scale asks respondents to rate their perception of support from the nurse practitioner in 5 situations on a 5-point scale ranging from never (0) to always (5), where higher scores indicate more perceived support.
20 weeks

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
The duration of each huddle in minutes was recorded by the nurse practitioner using the Huddle Observation Tool (HOT) (Edbrooke-Childs et al., 2018) as part of process evaluation.
Lasso di tempo: 15 weeks
Average and range of huddle duration were measured.
15 weeks
The attendance of different staff categories (i.e. personal support worker, registered practical nurse) at each huddle was recorded by the nurse practitioner using HOT (Edbrooke-Childs et al., 2018) as part of process evaluation.
Lasso di tempo: 15 weeks
Attendance of categories of staff at huddles was summarized as percentage of total huddles attended.
15 weeks
The frequency of delivery of huddles by the nurse practitioner was self-reported using HOT (Edbrooke-Childs et al., 2018) as part of process evaluation.
Lasso di tempo: 15 weeks
Data was summarized as total number of huddles delivered and number of huddles delivered per week.
15 weeks
Adherence to huddle structure was self-reported by the nurse practitioner using HOT (Edbrooke-Childs et al., 2018) as part of process evaluation.
Lasso di tempo: 15 weeks
Data included huddle topic and aim, sharing of a positive event, maintaining a collaborative culture, and creation of a risk management plan and was summarized as number of huddles adhering to the structure.
15 weeks
Depressive symptoms of residents residing on the intervention and control units will be measured with the Depression Rating Scale before and after implementation of huddles.
Lasso di tempo: 1 year
This is a quality indicator obtained from the Resident Assessment Instrument - Minimum Data Set (RAI-MDS) 2.0. Depression Rating Scale is based on the following items: negative statements (E1a), persistent anger (E1d), expression of unrealistic fears (E1f), repetitive health complaints (E1h), repetitive anxious complaints (E1ii), sad, pained, worried facial expression (E1l), crying, tearfulness (E1m). The score ranges from 0 to 14, where a score of 3 or more may indicate a potential or actual problem with depression.
1 year
Aggression of residents residing on the intervention and control units will be measured with the Aggressive Behaviour Scale before and after implementation of huddles.
Lasso di tempo: 1 year
This is a quality indicator obtained from the RAI-MDS 2.0. Aggressive Behaviour Scale is based on the following items: verbally abusive (E4b), physically abusive (E4c), socially inappropriate/disruptive behaviour (E4d), resists care (E4e). Scores range from 0 to 12, where higher scores indicate higher levels of aggressive behaviour.
1 year
The cognitive status of residents on the intervention and control units will be measured with the Cognitive Performance Scale before and after implementation of huddles.
Lasso di tempo: 1 year
This is a quality indicator obtained from the RAI-MDS 2.0. Cognitive Performance Scale is based on the following items: comatose (B1), short-term memory (B2a), cognition skills for daily decision-making (B4), expressive communication (C4), eating (G1hA). The sores range from 0 to 6, where higher scores indicate more severe cognitive impairment.
1 year
Changes in health, end-stage disease, and signs and symptoms of residents on the intervention and control units will be measured using the CHESS scale before and after implementation of huddles.
Lasso di tempo: 1 year
This is a quality indicator obtained from the RAI-MDS 2.0. CHESS is based on the following items: decline in cognition (B6), decline in ADL (G9), dehydration (J1c), edema (J1g), shortness of breath (J1l), vomiting (J1o), end-stage disease (J5c), weight loss (K3a), leaving food uneaten (K4c). The score ranges from 0 to 5, where higher scores indicate higher levels of medical complexity and are associated with adverse outcomes.
1 year
Changes in social engagement of residents on the intervention and control units will be measured with the Index of Social Engagement (ISE) before and after implementation of huddles.
Lasso di tempo: 1 year
This is a quality indicator obtained from the RAI-MDS 2.0. ISE is based on the following items: at ease interacting with others (F1a), at ease doing planned or structured activities (F1b), at ease doing self-initiated activities (F1c), establishes own goals (F1d), pursues involvement in the life of the facility (F1e), accepts invitations into most group activities (F1f). The scores range from 0-6, where higher scores indicate higher levels of social engagement.
1 year

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Toronto Rehabilitation Institute

Collaboratori

Canadian Institutes of Health Research (CIHR)
Centre for Aging and Brain Health Innovation
Canadian Foundation for Health Improvement
Walter & Maria Schroeder Institute for Brain Innovation and Recovery

Investigatori

  • Investigatore principale: Katherine S McGilton, KITE Research Institute - Toronto Rehabilitation Institute

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Collegamenti utili

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

14 maggio 2021

Completamento primario (Effettivo)

1 novembre 2021

Completamento dello studio (Effettivo)

1 novembre 2021

Date di iscrizione allo studio

Primo inviato

13 maggio 2022

Primo inviato che soddisfa i criteri di controllo qualità

18 maggio 2022

Primo Inserito (Effettivo)

24 maggio 2022

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

24 maggio 2022

Ultimo aggiornamento inviato che soddisfa i criteri QC

18 maggio 2022

Ultimo verificato

1 maggio 2022

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • 20-6298

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Descrizione del piano IPD

No IPD will be shared with other researchers.

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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