Improving medication administration in nursing home residents with swallowing difficulties: sustainability of the effect of a multifaceted medication safety programme

Stuijt, Clementine C. M.; Klopotowska, Joanna E.; Driel, Chantal Kluft van; Le, Nhut; Binnekade, Jan M.; Kleij, Bea van der; Schors, Tjalling van der; Bemt, Patricia M. L. A. van den; Lie‐A‐Huen, Loraine

doi:10.1002/pds.3373

Cited by 24 publications

(37 citation statements)

References 19 publications

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“…Staff turnover, high workload, concurrent projects, cancelled meetings and organizational changes were described as barriers for implementing the care program. It is not the first time these organizational factors have been found to be of influence on the implementation of an intervention in nursing home care [7]. It seems that, although the extent of the project and the time investment is explained before the start of the project, the decision to participate in a project is often made by managers, without consultation of team members of the DSCU.…”

Section: Discussionmentioning

confidence: 99%

Grip on challenging behavior: process evaluation of the implementation of a care program

Zwijsen

Smalbrugge

Eefsting³

et al. 2014

Trials

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BackgroundThe Grip on Challenging Behavior care program for managing challenging behavior was implemented in the dementia special care units of 17 Dutch nursing homes. A process evaluation of the implementation of the care program was performed to determine the quality of the implementation and the lessons to be learned for future implementation.MethodsThe care program was implemented according to a stepped wedge design. First-order data (data on recruitment, reach, relevance and feasibility) were used to determine the validity of the study, and second-order data (intervention quality and the barriers and facilitators for implementing the care program) were used to describe the implementation process. Two structured questionnaires were administered to care staff and key stakeholders and semi-structured interviews were held in the units.ResultsUniversity affiliated and non-affiliated nursing homes from different parts of the Netherlands participated. The resident participation rate was over 95% and the participation rate for the training sessions was 82%. Respondents considered the care program relevant and feasible. The degree of implementation was not optimal. The barriers and facilitators in implementing the care program could be divided into three categories: organizational aspects, culture on the unit and aspects of the care program itself.ConclusionsThe recruitment, reach, relevance and feasibility are sufficient to allow for analysis and generalization of the effects of the care program, but the degree of implementation should be taken into account in further analysis. Future projects that involve implementation should consider the specific features of the organization and the cultural orientation of the unit to better adapt to specific needs.Trial registrationThe Netherlands National Trial register under number NTR2141 registered on 11 December 2009. Randomization took place in November 2010, and the first intervention group started using the intervention in February 2011.Electronic supplementary materialThe online version of this article (doi:10.1186/1745-6215-15-302) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Grip on challenging behavior: process evaluation of the implementation of a care program

Zwijsen

Smalbrugge

Eefsting³

et al. 2014

Trials

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“…Additionally, we only assessed the immediate effect of the intervention program. It is well known that the training of healthcare staff and the effect of an intervention program may vanish over time and that the number of errors could be biased by the presence of a monitoring person and then be underestimated (Hawthorne effect). However, if the program triggers workflow changes and, hence, is anchored in clinical routine (like on the surgical ward), training and education effects might persist over time …”

Section: Discussionmentioning

confidence: 99%

More than just crushing: a prospective pre-post intervention study to reduce drug preparation errors in patients with feeding tubes

et al. 2015

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“…Indeed, various researchers have already emphasised the importance of commitment and investment of care organisations when implementing changes in care practice (Stuijt et al, 2013;Celik et al, 2012;Ouslander et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Coming to grips with challenging behaviour: A cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units

Zwijsen¹,

Gerritsen²,

Eefsting³

et al. 2015

International Journal of Nursing Studies

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Please cite this article as: Zwijsen, S.A., Gerritsen, D.L., Eefsting, J.A., Smalbrugge, M., Hertogh, C.M.P.M., Pot, A.M.,Coming to grips with challenging behaviour: a cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units., International Journal of Nursing Studies (2014), http://dx.doi.org/10. 1016/j.ijnurstu.2014.10.003 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A c c e p t e d M a n u s c r i p tWhat is already known?-Caring for people with dementia is a demanding job -Job satisfaction of care staff is, amongst other things, influenced by challenging behaviour of residents What this paper adds:-The introduction of a care programme that provides the multidisciplinary team with education and tools to structure the process of detecting, analysing, treatment and evaluation of treatment of challenging behaviour. -By using the care programme, job satisfaction of care staff can be improved without increasing job demands Objectives: To determine the effects of a care programme for the challenging behaviour of nursing home residents with dementia on the burnout, job satisfaction and job demands of care staff. Design:The care programme was implemented according to a stepped wedge design in which care units were randomly divided over five groups with different time points of starting with implementation.Setting: 17 Dutch dementia special care units. Participants:Care staff members of the 17 units. Intervention:The care programme consists of an education package and of various structured assessment tools that guide professionals through the multidisciplinary detection, analysis, treatment and evaluation of treatment of challenging behaviour. Results: Of the 1441 questionnaires, 645 were returned (response 45%, 318 control measurements, 327 intervention measurements) by 380 unique care staff members.Significant effects were found on job satisfaction (0.93, 95% CI 0.48 to 1.38). On the other outcomes, no significant changes in the scores were found. Conclusion:Positive effects of using the Grip on Challenging behaviour care programme were found on job satisfaction, without an increase in job demands.

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Improving medication administration in nursing home residents with swallowing difficulties: sustainability of the effect of a multifaceted medication safety programme

Abstract: Introduction of a multifaceted medication safety programme in NH facilities by a pharmacy team is a tool towards safer medication administration practice in residents with swallowing difficulties. Commitment on organisational level is, however, vital to achieve sustainable improvements.

Cited by 24 publications

References 19 publications

Grip on challenging behavior: process evaluation of the implementation of a care program

Grip on challenging behavior: process evaluation of the implementation of a care program

More than just crushing: a prospective pre-post intervention study to reduce drug preparation errors in patients with feeding tubes

Coming to grips with challenging behaviour: A cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units

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