Researching Early Detection of Deterioration In Elderly residents

EDDIE+ Intervention exposure The intervention consists of four components. 1. Education and training of all nursing and care staff A nurse educator will deliver face-to-face training sessions for all Residential Aged Care (RAC) home nursing and care staff on early identification of deterioration and response. Teaching and learning strategies will be tailored to meet individual RAC home needs and may also include online content delivery. Core delivery will consist of two, one hour session delivered during the four week Intervention introduction phase. Duration and frequency of sessions will be tailored to suit RAC home backfill arrangements. Training will be developed to align with relevant existing Bolton Clarke policies and procedures, Department of Health guidelines, Queensland Ambulance guidelines and existing hospital avoidance initiatives. 2. Decision support tools A core decision support tools covering clinical decision-making guidelines for managing deterioration for a number of conditions will be available to nursing and care staff. The tools will reflect best practice clinical guidelines and align with Bolton Clarke policies and procedures. Their use and function will be covered in the face to face training sessions. The decision support tools will be made available to all RAC home staff throughout the intervention period with the aim of embedding use into business as usual practices. 3. Diagnostic medical equipment Each participating RAC home will provided with medical equipment as identified in the environmental scan and mapping exercise at each site: o Bladder scanner o ECG machine o Pulse oximeters o Vital signs monitor 4. Implementation facilitation and clinical systems support Each site will have one internal facilitator who will assist with implementation and facilitation of the project at their site. This facilitator will also work closely with the nurse educator and an experienced implementation scientist to enable and support the implementation process and to embed the program into standard business practices. This may include regular stakeholder engagement, working with management to develop new business policies and practices and close collaboration with nursing and care staff including ‘on the job’ support and training. The study will use a stepped-wedge design with the intervention exposure phase running for 4 to 48 weeks. Intervention adherence and fidelity will be monitored by the project team. The project team will have fortnightly contact Bolton Clarke facilitator at each site where fidelity will be monitored. Strategies to maintain and improve fidelity will be tailored to suit site requirements. Strategies include reminder posters will be displayed in staff common areas and reminder messages distributed through usual staff communication channels, such as team meetings, shift change over meetings, email.