Franziska Zúñiga1, Sabina De Geest1,2, Raphaëlle Ashley Guerbaai1, Kornelia Basinska1, Dunja Nicca1,3, Reto W Kressig4,5, Andreas Zeller5,6, Nathalie I H Wellens7, Carlo De Pietro8, Ellen Vlaeyen1,2, Mario Desmedt9, Christine Serdaly10, Michael Simon1,11. 1. Department Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Basel, Switzerland. 2. Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium. 3. Department of Nursing and Allied Health Professions, University Hospital Basel, Basel, Switzerland. 4. University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland. 5. Faculty of Medicine, University of Basel, Basel, Switzerland. 6. Center for Primary Health Care, University of Basel, Basel, Switzerland. 7. Department of Public Health and Social Affairs of the Canton of Vaud, Lausanne, Switzerland. 8. Department of Business Economics, Health and Social Care at the University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland. 9. Foundation Asile des Aveugles, Lausanne, Switzerland. 10. serdaly&ankers, Conches, Switzerland. 11. Inselspital Bern University Hospital, Nursing & Midwifery Research Unit, Bern, Switzerland.
Abstract
OBJECTIVES: Nursing home (NH) residents with complex care needs ask for attentive monitoring of changes and appropriate in-house decision making. However, access to geriatric expertise is often limited with a lack of geriatricians, general practitioners, and/or nurses with advanced clinical skills, leading to potentially avoidable hospitalizations. This situation calls for the development, implementation, and evaluation of innovative, contextually adapted nurse-led care models that support NHs in improving their quality of care and reducing hospitalizations by investing in effective clinical leadership, geriatric expertise, and care coordination. DESIGN: An effectiveness-implementation hybrid type 2 design to assess clinical outcomes of a nurse-led care model and a mixed-method approach to evaluate implementation outcomes will be applied. The model development, tailoring, and implementation are based on the Consolidated Framework for Implementation Research (CFIR). SETTING: NHs in the German-speaking region of Switzerland. PARTICIPANTS: Eleven NHs were recruited. The sample size was estimated assuming an average of .8 unplanned hospitalizations/1000 resident days and a reduction of 25% in NHs with the nurse-led care model. INTERVENTION: The multilevel complex context-adapted intervention consists of six core elements (eg, specifically trained INTERCARE nurses or evidence-based tools like Identify, Situation, Background, Assessment and Recommendation [ISBAR]). Multilevel implementation strategies include leadership and INTERCARE nurse training and support. MEASUREMENTS: The primary outcomes are unplanned hospitalizations/1000 care days. Secondary outcomes include unplanned emergency department visits, quality indicators (eg, physical restraint use), and costs. Implementation outcomes included, for example, fidelity to the model's core elements. CONCLUSION: The INTERCARE study will provide evidence about the effectiveness of a nurse-led care model in the real-world setting and accompanying implementation strategies. J Am Geriatr Soc 67:2145-2150, 2019.
OBJECTIVES: Nursing home (NH) residents with complex care needs ask for attentive monitoring of changes and appropriate in-house decision making. However, access to geriatric expertise is often limited with a lack of geriatricians, general practitioners, and/or nurses with advanced clinical skills, leading to potentially avoidable hospitalizations. This situation calls for the development, implementation, and evaluation of innovative, contextually adapted nurse-led care models that support NHs in improving their quality of care and reducing hospitalizations by investing in effective clinical leadership, geriatric expertise, and care coordination. DESIGN: An effectiveness-implementation hybrid type 2 design to assess clinical outcomes of a nurse-led care model and a mixed-method approach to evaluate implementation outcomes will be applied. The model development, tailoring, and implementation are based on the Consolidated Framework for Implementation Research (CFIR). SETTING: NHs in the German-speaking region of Switzerland. PARTICIPANTS: Eleven NHs were recruited. The sample size was estimated assuming an average of .8 unplanned hospitalizations/1000 resident days and a reduction of 25% in NHs with the nurse-led care model. INTERVENTION: The multilevel complex context-adapted intervention consists of six core elements (eg, specifically trained INTERCARE nurses or evidence-based tools like Identify, Situation, Background, Assessment and Recommendation [ISBAR]). Multilevel implementation strategies include leadership and INTERCARE nurse training and support. MEASUREMENTS: The primary outcomes are unplanned hospitalizations/1000 care days. Secondary outcomes include unplanned emergency department visits, quality indicators (eg, physical restraint use), and costs. Implementation outcomes included, for example, fidelity to the model's core elements. CONCLUSION: The INTERCARE study will provide evidence about the effectiveness of a nurse-led care model in the real-world setting and accompanying implementation strategies. J Am Geriatr Soc 67:2145-2150, 2019.
Authors: Jana Bartakova; Franziska Zúñiga; Raphaëlle-Ashley Guerbaai; Kornelia Basinska; Thekla Brunkert; Michael Simon; Kris Denhaerynck; Sabina De Geest; Nathalie I H Wellens; Christine Serdaly; Reto W Kressig; Andreas Zeller; Lori L Popejoy; Dunja Nicca; Mario Desmedt; Carlo De Pietro Journal: BMC Geriatr Date: 2022-06-09 Impact factor: 4.070
Authors: Kornelia Basinska; Nathalie I H Wellens; Michael Simon; Andreas Zeller; Reto W Kressig; Franziska Zúñiga Journal: J Adv Nurs Date: 2020-11-22 Impact factor: 3.187
Authors: Franziska Zúñiga; Raphaëlle-Ashley Guerbaai; Sabina de Geest; Lori L Popejoy; Jana Bartakova; Kris Denhaerynck; Diana Trutschel; Kornelia Basinska; Dunja Nicca; Reto W Kressig; Andreas Zeller; Nathalie I H Wellens; Carlo de Pietro; Mario Desmedt; Christine Serdaly; Michael Simon Journal: J Am Geriatr Soc Date: 2022-02-05 Impact factor: 7.538
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