Aged care clinical mentoring model of change in nursing homes in China: study protocol for a cluster randomized controlled trial

• Published in: BMC health services research 2018-10, Vol.18 (1), p.816-816, Article 816
• Main Authors: Feng, Hui, Li, Hui, Xiao, Lily Dongxia, Ullah, Shahid, Mao, Pan, Yang, Yunxia, Hu, Hengyu, Zhao, Yinan
• Format: Article
• Language: English
• Subjects: Accidental Falls - prevention & control; Aged; China; Clinical trials; Cluster Analysis; Cluster randomized controlled trial; Cost-Benefit Analysis; Delivery of Health Care - economics; Delivery of Health Care - standards; Dementia; Education; Elder care; Employment; Evidence-based nursing; Female; Health services; Health services administration; Homes for the Aged - standards; Humans; Hypotheses; Intervention; Job Satisfaction; Male; Management; Medical care quality; Mentoring; Mentoring - economics; Mentoring - standards; Mentors; Methods; Nursing home; Nursing home care; Nursing homes; Nursing Homes - economics; Nursing Homes - standards; Older people; Patient-centered care; Perceptions; Pressure ulcers; Quality; Quality control; Quality improvement; Quality Improvement - economics; Quality Improvement - standards; Quality management; Quality of care; Quality of Life; Randomized Controlled Trials as Topic; Sample Size; Study Protocol; Urinary incontinence; Well being; Womens health; Workforce
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-018-3596-6

Residents living in nursing homes usually have complex healthcare needs and require a comprehensive care approach to identifying and meeting their care needs. Suboptimal quality of care is reported in nursing homes and is associated with the poor health and well-being of the residents, the burden on acute care hospitals and the high costs of healthcare for the government. The aim of this study is to test the hypothesis that an Aged Care Clinical Mentoring Model will create and sustain evidence-based quality improvement in priority areas and will be cost-effective in nursing homes in Hunan Province, China. A cluster randomized controlled trial will be applied to the study. Fourteen nursing homes will be randomly allocated to either the intervention group (n = 7) or the control group (n = 7). Forty staff will be recruited from each nursing home and the estimated sample size will be 280 staff in each group. The intervention includes a structured, evidence-based quality improvement education program for staff to facilitate knowledge translation in evidence-based quality improvement targeting urinary incontinence, pressure injury and falls prevention. The primary outcomes are nursing homes' capacity to create and sustain quality improvement, staff perceptions of person-centered care, self-reported quality of care by residents and selected quality indicators at 12 months follow-up adjusted for baseline value. Secondary outcomes are residents' quality of life, residents' unplanned admissions to acute care hospitals, quality of care reported by staff, staff job satisfaction and staff intention to leave adjusted for baseline value. A mixed linear regression model will be adopted to compare the significant differences between groups over a 12-month period. Although the Aged Care Clinical Mentoring Model has been tested as an effective model to bring positive changes in nursing homes in a high-income country, factors affecting the adaptation of the model in nursing homes in low- and middle-income countries are unknown. The carefully planned intervention protocol enables the project team to consider enablers and barriers when adapting the Model. Therefore, strategies and resources will be in place to manage challenges while demonstrating best practice in this study. Prospectively registered via Chinese Clinical Trial Registry (ChiCTR), ChiCTR-IOC-17013109 , Registered on 25 October 2017.