[PDF] Top 20 Implementing advance care planning in nursing homes – study protocol of a cluster-randomized clinical trial

... Randomized controlled trials are considered the best research design to measure effects of an intervention [43]. Still, there are elements to this study that make possible effects harder to assess. ... See full document

... by engaging in at least one informal conversation with a resident living with dementia and/or family. It is important to note that residents or families often implicitly or expli- citly express preferences or fears ... See full document

... readiness planning; (4) staff trained; (5) fidelity monitoring process in place; (6) implementation begins; (7) ongoing implementation, coaching, and feedback; and (8) ... See full document

... on nursing staff is relieved if the resi- dents ’ individual treatment preferences are known and the staff can assume that either implementing or for- going disputable treatment measures is in accordance ... See full document

... to care (e.g., if a con- dition impacts care of another ...in clinical care, many patients do not [62]. Finally, this study was limited to adults visiting family medicine ...to ... See full document

... The trial is designed as a cluster randomized controlled trial with 20 nursing homes in Saxony and Saxony-Anhalt (Germany) as the units of ...randomization. Nursing ... See full document

... One randomized controlled trial (RCT) of the “Respecting Choices” model for ACP, among elderly hospitalized pa- tients in Australia, has reported positive outcomes in en- abling people to receive EOL ... See full document

... within cluster depend- ency, the intracluster correlation coefficient (between home variance for urinary antibiotic prescription / sum of inter- and intra-home variance), was then calculated using data from the 12 ... See full document

... this study provide the basis for the further design and evaluation of an ACP intervention programme for nursing ...the nursing home setting in ...a cluster randomised controlled trial ... See full document

... interdisciplinary care conferences (ICCs) are held for more in-depth team discussion on care planning and coordinated ...preliminary care plans for the case are discussed and ...health ... See full document

... pilot, cluster randomized controlled trial in 40 LTC homes (21 control; 19 intervention) in Ontario, ...LTC homes were eligible if they had more than one prescribing physician and ... See full document

... meaningful clinical target for interventions since restlessness, agitation, aggression, delusions, apathy, disinhibition, and hallucinations are highly prevalent among residents with dementia [18] and pose a major ... See full document

... 36]. Protocol redundancies also gener- ated concern among Champions in PROVEN as well as other studies [36], most notably that repeatedly approaching patients and family regarding ACP could impair ongoing end-user ... See full document

... previous study was the resistance to the ACCM program from manage- ment and staff because staffing levels were low, and mentoring activities and changes in practice were viewed as additional workload for staff ... See full document

... these homes themselves we reviewed hospitalisation rates into the regions tertiary referral centre, as a refer- ence site, and found that there was no significant change in hospitalisations from LTC facilities ... See full document

... future care that typically included their relative be pain free and in comfort; non-essential medication to be discontinued; their relative to be able to die in the nursing home; availability of religious ... See full document

... health care wishes [11, ...the care they do or do not want to receive in an advance ...our study, a nurse practitioner followed the Re- specting Choices train-the-facilitators program in the ... See full document

... health care costs, hospital stays, more general practitioner visits, more intensive nursing care, increased requirement of nursing home-care ...for care and social services leads ... See full document

... Furthermore, cluster randomization reduces contamination between the trial arms as much as ...be randomized on an equal basis so an equal amount of teams and clients can participate in both ...the ... See full document

... based care, within which one-to-one visits are being replaced by group consultations ...of care – health assessment, education, and ...prenatal care, which is freely accessible to all women in the ... See full document