Pedro Gozalo1, Shivaani Prakash, Danya M Qato, Philip D Sloane, Vincent Mor. 1. Center for Gerontology and Health Care Research, School of Public Health, Brown University, Providence, Rhode Island; Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island.
Abstract
OBJECTIVES: To evaluate the effectiveness of the Bathing Without a Battle intervention in reducing physical and verbal aggressive behaviors for nursing home residents with dementia. DESIGN: A randomized crossover diffusion study, with one group receiving the intervention after one round of baseline observations and a delayed intervention group receiving the intervention after two rounds of baseline observations. SETTING:Six nursing home facilities in the state of New York. PARTICIPANTS: Nursing home residents with dementia (N = 240). INTERVENTION: The Bathing Without a Battle educational program, designed for direct-care staff members responsible for bathing residents diagnosed with dementia and implemented through a train-the-trainer model. MEASUREMENTS: Rates of verbal and physical aggressive and agitated behaviors were measured using the Care Recipient Behavior Assessment; secondary measures of effect included bath duration, bath modality, and antipsychotic medication use. RESULTS: In spite of implementation obstacles (consent delays and change in leadership at one facility), a significant change was observed in how residents were bathed that translated into a significant reduction in the rate of aggressive and agitated behaviors, particularly verbal, during residents' baths. The use of in-bed baths increased 17%, and average bath duration decreased significantly (average 1.5 minutes less) in the postintervention period, particularly for in-bed baths. Verbal behaviors declined 17.8% (P = .008), combined verbal and physical behaviors declined 18.6% (P = .004), and antipsychotic use declined 30% (P = .002) after the intervention. CONCLUSION: The Bathing Without a Battle educational program, delivered through a train-the-trainer format, is an effective means of improving the bathing experience of residents with dementia in nursing homes. This research supports broadly adopting this intervention, especially for nursing homes serving many residents with dementia.
RCT Entities:
OBJECTIVES: To evaluate the effectiveness of the Bathing Without a Battle intervention in reducing physical and verbal aggressive behaviors for nursing home residents with dementia. DESIGN: A randomized crossover diffusion study, with one group receiving the intervention after one round of baseline observations and a delayed intervention group receiving the intervention after two rounds of baseline observations. SETTING: Six nursing home facilities in the state of New York. PARTICIPANTS: Nursing home residents with dementia (N = 240). INTERVENTION: The Bathing Without a Battle educational program, designed for direct-care staff members responsible for bathing residents diagnosed with dementia and implemented through a train-the-trainer model. MEASUREMENTS: Rates of verbal and physical aggressive and agitated behaviors were measured using the Care Recipient Behavior Assessment; secondary measures of effect included bath duration, bath modality, and antipsychotic medication use. RESULTS: In spite of implementation obstacles (consent delays and change in leadership at one facility), a significant change was observed in how residents were bathed that translated into a significant reduction in the rate of aggressive and agitated behaviors, particularly verbal, during residents' baths. The use of in-bed baths increased 17%, and average bath duration decreased significantly (average 1.5 minutes less) in the postintervention period, particularly for in-bed baths. Verbal behaviors declined 17.8% (P = .008), combined verbal and physical behaviors declined 18.6% (P = .004), and antipsychotic use declined 30% (P = .002) after the intervention. CONCLUSION: The Bathing Without a Battle educational program, delivered through a train-the-trainer format, is an effective means of improving the bathing experience of residents with dementia in nursing homes. This research supports broadly adopting this intervention, especially for nursing homes serving many residents with dementia.
Authors: Beverly Hoeffer; Karen Amann Talerico; Joyce Rasin; C Madeline Mitchell; Barbara J Stewart; Darlene McKenzie; Ann Louise Barrick; Joanne Rader; Philip D Sloane Journal: Gerontologist Date: 2006-08
Authors: Kevin E Thorpe; Merrick Zwarenstein; Andrew D Oxman; Shaun Treweek; Curt D Furberg; Douglas G Altman; Sean Tunis; Eduardo Bergel; Ian Harvey; David J Magid; Kalipso Chalkidou Journal: J Clin Epidemiol Date: 2009-05 Impact factor: 6.437
Authors: Sheryl Zimmerman; Wayne L Anderson; Shannon Brode; Dan Jonas; Linda Lux; Anna S Beeber; Lea C Watson; Meera Viswanathan; Kathleen N Lohr; Philip D Sloane Journal: J Am Geriatr Soc Date: 2013-07-19 Impact factor: 5.562
Authors: Philip D Sloane; Beverly Hoeffer; C Madeline Mitchell; Darlene A McKenzie; Ann Louise Barrick; Joanne Rader; Barbara J Stewart; Karen Amann Talerico; Joyce H Rasin; Richard C Zink; Gary G Koch Journal: J Am Geriatr Soc Date: 2004-11 Impact factor: 5.562
Authors: Rita A Jablonski-Jaudon; Vicki Winstead; Corteza Jones-Townsend; Andres Azuero; Ellen Mahoney; Ann M Kolanowski Journal: J Nurs Meas Date: 2016
Authors: Fabian M V Groven; Sandra M G Zwakhalen; Gaby Odekerken-Schröder; Erik J T Joosten; Jan P H Hamers Journal: BMC Geriatr Date: 2017-01-25 Impact factor: 3.921