The champion for improved delivery of care to older people in long-term care settings: effects on professional practice, quality of care and resident outcomes

Welsh, Sheila; Sherriff, Andrea; Flodgren, Gerd

doi:10.1002/14651858.cd011956

Cited by 6 publications

(2 citation statements)

References 32 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The seven-month practice change intervention to support the implementation of the recommended model of care into routine clinical practice consisted of the following evidence-based strategies: leadership/managerial supervision ( Flodgren et al, 2011 ); local clinical practice guidelines ( Rotter et al, 2010 ); electronic prompts and reminders ( Shojania et.al, 2014 ); local opinion leaders/champions ( Flodgren et al, 2011 ;Welsh et al, 2015 ;Woo et al, 2017 ); educational meetings and materials ( Forsetlund et al, 2009 ;Reeves et al, 2013 ); academic detailing (including audit and feedback) ( Chaillet et al, 2006 ;Ivers et al, 2012 ;O'Brien et al, 2007 ); and monitoring and accountability for performance ( Ivers et al, 2012 ). Intervention development was guided by the Theoretical Domains Framework ( Cane et al, 2012 ;Michie et al, 2005 ) with implementation strategy selection targeting system and individual clinician level barriers elicited from formative surveys with ante-natal providers in the participating services Kingsland et al, 2018 ).…”

Section: Interventionmentioning

confidence: 99%

Differential effectiveness of a practice change intervention to improve antenatal care addressing alcohol consumption during pregnancy: Exploratory subgroup analyses within a randomised stepped-wedge controlled trial

et al. 2023

View full text Add to dashboard Cite

Section: Interventionmentioning

confidence: 99%

Differential effectiveness of a practice change intervention to improve antenatal care addressing alcohol consumption during pregnancy: Exploratory subgroup analyses within a randomised stepped-wedge controlled trial

et al. 2023

View full text Add to dashboard Cite

“…20 The effect sizes in both studies were at the upper end of implementation trial outcomes as reported in Cochrane systematic reviews. [21][22][23][24][25][26][27][28][29][30] However, half or fewer reported receipt of the recommended care elements after implementation support, leaving many women without the intended benefits of the clinical guidelines. Such a finding is consistent with the clinical practice change literature generally, which indicates that despite significant effect sizes in trials, the interventions do not result in the majority of patients receiving guideline recommended care.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Iterative delivery of an implementation support package to increase and sustain the routine provision of antenatal care addressing alcohol consumption during pregnancy: study protocol for a stepped-wedge cluster trial

et al. 2022

View full text Add to dashboard Cite

IntroductionAntenatal care addressing alcohol consumption during pregnancy is not routinely delivered in maternity services. Although a number of implementation trials have reported significant increases in such care, the majority of women still did not receive all recommended care elements, and improvements dissipated over time. This study aims to assess the effectiveness of an iteratively developed and delivered implementation support package in: (1) increasing the proportion of pregnant women who receive antenatal care addressing alcohol consumption and (2) sustaining the rate of care over time.Methods and analysisA stepped-wedge cluster trial will be conducted as a second phase of a previous trial. All public maternity services within three sectors of a local health district in Australia will receive an implementation support package that was developed based on an assessment of outcomes and learnings following the initial trial. The package will consist of evidence-based strategies to support increases in care provision (remind clinicians; facilitation; conduct educational meetings) and sustainment (develop a formal implementation blueprint; purposely re-examine the implementation; conduct ongoing training). Measurement of outcomes will occur via surveys with women who attend antenatal appointments each week. Primary outcomes will be the proportion of women who report being asked about alcohol consumption at subsequent antenatal appointments; and receiving complete care (advice and referral) relative to alcohol risk at initial and subsequent antenatal appointments. Economic and process evaluation measures will also be reported.Ethics and disseminationEthical approval was obtained through the Hunter New England (16/11/16/4.07, 16/10/19/5.15) and University of Newcastle Human Research Ethics Committees (H-2017-0032, H-2016-0422) and the Aboriginal Health and Medical Research Council (1236/16). Trial findings will be disseminated to health service decision makers to inform the feasibility of conducting additional cycles to further improve antenatal care addressing alcohol consumption as well as at scientific conferences and in peer-reviewed journals.Trial registration numberAustralian and New Zealand Clinical Trials Registry (ACTRN12622000295741).

show abstract

Antenatal care for alcohol consumption during pregnancy: pregnant women’s reported receipt of care and associated characteristics

Doherty

Wiggers

Wolfenden

et al. 2019

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Antenatal clinical guidelines recommend that during initial and subsequent antenatal visits all pregnant women: have their alcohol consumption assessed; be advised that it is safest not to consume alcohol during pregnancy and of the potential risks of consumption; and be offered referrals for further support if required. However, the extent to which pregnant women attending public antenatal services receive guideline recommended care at these visits, and the characteristics associated with its receipt, is unknown. The purpose of this study was to examine: 1) pregnant women’s reported receipt of guideline recommended care addressing alcohol consumption during pregnancy; 2) characteristics associated with the receipt of care; and 3) pregnant women’s acceptability of care. Methods From July 2017 – February 2018 a survey (telephone or online) was undertaken with 1363 pregnant women who had recently visited a public antenatal service in one health district in Australia. Receipt and acceptability of recommended care were assessed via descriptive statistics and associations via logistic regression analyses. Results At the initial antenatal visit, less than two thirds (64.3%) of pregnant women reported that they received an assessment of their alcohol consumption and just over one third (34.9%) received advice and referral appropriate to their self-reported level of alcohol consumption since pregnancy recognition. Less than 10% of women received such care at subsequent antenatal visits. Characteristics that significantly increased the odds of receiving all guideline elements at the initial antenatal visit included: less than university attainment (OR = 1.93; 95% CI:1.12, 3.34), not residing in an advantaged area (OR = 2.11; 95% CI:1.17, 3.79), first pregnancy (OR = 1.91; 95% CI:1.22, 2.99) and regional/rural service location (OR = 2.38; 95% CI:1.26, 4.48); and at subsequent visits: younger age (OR = 0.91; 95% CI:0.84, 0.99) and Aboriginal origin (OR = 3.17; 95% CI:1.22, 8.24). Each of the recommended care elements were highly acceptable to pregnant women (88.3–99.4%). Conclusions Although care for alcohol consumption is both recommended by clinical guidelines and highly acceptable to pregnant women, its receipt in public antenatal services is suboptimal. There is a need and an opportunity for interventions to support antenatal care providers to routinely and consistently provide such care to all pregnant women.

show abstract

The champion for improved delivery of care to older people in long-term care settings: effects on professional practice, quality of care and resident outcomes

Abstract: The champion for improved delivery of care to older people in long-term care settings: effects on professional practice, quality of care and resident outcomes.

Cited by 6 publications

References 32 publications

Differential effectiveness of a practice change intervention to improve antenatal care addressing alcohol consumption during pregnancy: Exploratory subgroup analyses within a randomised stepped-wedge controlled trial

Differential effectiveness of a practice change intervention to improve antenatal care addressing alcohol consumption during pregnancy: Exploratory subgroup analyses within a randomised stepped-wedge controlled trial

Iterative delivery of an implementation support package to increase and sustain the routine provision of antenatal care addressing alcohol consumption during pregnancy: study protocol for a stepped-wedge cluster trial

Antenatal care for alcohol consumption during pregnancy: pregnant women’s reported receipt of care and associated characteristics

Contact Info

Product

Resources

About