Nurse led care coordination: Trial protocol and development of a best practice resource guide for a cluster controlled clinical trial in Australian aged care facilities

Arendts, Glenn; Etherton‐Beer, Christopher; Howard, Kirsten; Lewin, Gill; Sim, Moira; Pickstock, Sarah; Fitzhardinge, Sarah; O'Brien, Keith; Tassell, Shannon; Deans, Pamela; Blackwell, Scott

doi:10.1016/j.archger.2013.07.004

Cited by 11 publications

(6 citation statements)

References 31 publications

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“…For instance, some hospital care could be alternatively provided on site in RACFs, including urinary catheter change, administering intravenous antibiotics, wound care, PEG tube, etc., which is among the practices of our studied intervention. Early intervention or additional acute care at RACFs reduces residents’ need to attend hospitals for extended care; and as a result, patients will probably have improved clinical outcomes and quality of care [ 2 , 3 , 12 , 27 , 28 ]. We assume so because the frail RACF residents are often prone to adverse events associated with ED and hospital attendances, and the hospital environment itself is unsuited for the special and complex needs of elderly RACF residents.…”

Section: Discussionmentioning

confidence: 99%

Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study

Fan

Hou

Zhao³

et al. 2015

BMC Health Serv Res

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BackgroundThere has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs).MethodsA quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis.ResultsSignificant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67–0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50–0.76); p < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43–0.85); p = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65–0.86); p < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54–0.79); p < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61–1.11); p = 0.196).ConclusionsHospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.

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Section: Discussionmentioning

confidence: 99%

Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study

Fan

Hou

Zhao³

et al. 2015

BMC Health Serv Res

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“…As a result, 13 studies of 12 nurse‐led care models were included in the review (Arendts et al, 2018; Borbasi et al, 2011; Day et al, 2014; Dwyer et al, 2017; Ersek et al, 2018; Giebel et al, 2020; Kaasalainen et al, 2016; Kane et al, 2003, 2004; Kim et al, 2020; Koekkoek et al, 2016; Lacny et al, 2016; Rantz et al, 2017) (Figure 1). Six protocol papers or general model reports (Arendts et al, 2014; Borbasi et al, 2010; Kane & Huck, 2000; Kim et al, 2017; Rantz et al, 2014; Unroe et al, 2015) were used to obtain additional information regarding the structure and the content of the included models or the methodology of the study.…”

Section: Resultsmentioning

confidence: 99%

Core elements and potential of nurse‐led care models in residential long‐term care: A scoping review

Schmüdderich

Kiwitt

Palm

et al. 2022

Journal of Clinical Nursing

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Aims and objective To identify and summarise core elements, resident‐, staff‐ and process‐related outcomes and challenges of nurse‐led care models in residential long‐term care. Background Due to demographic trends, the complexity of residential long‐term care has increased. To address this complexity, the implementation of nurse‐led care models has been recommended. Design Scoping review. Methods A systematic search was conducted of English and German articles in CINAHL via EBSCO, MEDLINE via PubMed, Cochrane Library and Scopus. Forward and backward citation tracking via reference lists and Google Scholar supplemented the search. The final update was made on 19 January 2021. To draw conclusions about the potential of nurse‐led care models, evaluation studies of the described models for residents in nursing homes were included. Full texts were independently screened and assessed for methodological quality. Data were extracted and summarised in tables and synthesised for analysis. The core elements of the models were described using the Sustainable intEgrated chronic care modeLs for multimorbidity: delivery, FInancing and performancE (SELFIE) framework. The review followed the PRISMA‐ScR guideline. Results We included 13 studies of 12 nurse‐led care models. The different models comprised many of the core elements suggested in the SELFIE framework, particularly in the components service delivery, workforce, and leadership and governance. The studies reported a broad range of resident‐, staff‐ and process‐related outcomes and challenges considered relevant to the success of the models. Conclusions Studies evaluating nurse‐led care models in nursing homes are limited and of moderate quality. This review demonstrates that nurse‐led care models include many elements for care coordination and could improve resident‐, staff‐ and process‐related outcomes. Relevance to clinical practice This review highlights that nurse‐led care models share common core elements despite their heterogeneity. It also shows that highly qualified nurses in nurse‐led care models can advance nursing practice in nursing homes.

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“…Nursing home residents were recruited to a multicentre open label cluster controlled trial of nurse led care coordination in Perth, Western Australia (Australian and New Zealand Clinical Trials Registry number 12611000933954). In brief, individuals were eligible for the study if they were 65 year or older, eligible for Medicare and a permanent high level care resident in an accredited facility [ 17 ]. The EQ-5D-3L and HUI3 questionnaires were administered at baseline and 6-month follow-up, and co-morbidities were measured using the Charlson co-morbidity index [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Comparison of the HUI3 and the EQ-5D-3L in a nursing home setting

et al. 2017

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BackgroundAccurately assessing changes in the quality of life of older people living permanently in nursing homes is important. The multi-attribute utility instrument most commonly used and recommended to assess health-related quality of life in the nursing home population is the three-level EuroQol EQ-5D-3L. To date, there have been no studies using the Health Utilities Index Mark III (HUI3). The purpose of this study was to compare the level of agreement and sensitivity to change of the EQ-5D-3L and HUI3 in a nursing home population.MethodsEQ-5D-3L and HUI3 scores were measured as part of a cluster randomised controlled trial of nurse led care coordination in a nursing home population in Perth, Western Australia at baseline and 6-month follow up.ResultsBoth measures were completed for 199 residents at baseline and 177 at 6-month follow-up. Mean baseline utility scores for EQ-5D-3L (0.45; 95% CI 0.41–0.49) and HUI3 (0.15; 95% CI 0.10–0.20) were significantly different (Wilcoxon signed rank test, p<0.01) and agreement was poor to moderate between absolute scores from each instrument (intra-class correlation coefficient = 0.63). The EQ-5D-3L appeared more sensitive to change over the 6-month period.ConclusionOur findings show that the EQ-5D-3L and HUI3 estimate different utility scores among nursing home residents. These differences should be taken into account, particularly when considering the implications of the cost-effectiveness of particular interventions and we conclude that the HUI3 is no better suited to measuring health-related quality of life in a nursing home population when compared to the EQ-5D-3L.

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Nurse led care coordination: Trial protocol and development of a best practice resource guide for a cluster controlled clinical trial in Australian aged care facilities

Cited by 11 publications

References 31 publications

Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study

Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: a quasi-experimental study

Core elements and potential of nurse‐led care models in residential long‐term care: A scoping review

Comparison of the HUI3 and the EQ-5D-3L in a nursing home setting

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