Dementia
Conditions
Keywords
Nursing Homes, Implementation of innovative programs, Nursing staff, Nurses' aides, Educational models
Brief summary
This study aimed to explore the feasibility of an educational intervention to strengthen workplace learning systems in four VA Community Living Centers (CLCs).
Detailed description
Background: The study explored the feasibility of an educational intervention to strengthen workplace-learning systems in four VA Community Living Centers (CLCs). Objectives: Specific aims were to 1) conduct a feasibility study to assess whether the educational intervention is practical to implement as designed and 2) conduct a pilot study to validate the methodology proposed for assessing outcomes of this educational intervention. Methods: A multi-level intervention targeting the translation of workplace learning into practice was implemented. The Direct Care Worker (DCW) intervention targeted both clinical knowledge and effective communication. The Coaching Supervision training addressed management and supervision practices for nurses, combined with effective communication. Four CLCs received both interventions, administered by the Paraprofessional Health Institute (PHI), using a train-the-trainer approach over the course of four 3-day sessions. Quantitative and qualitative data were collected to assess factors influencing effectiveness of implementation and to understand the impact of the trainings on participants. Status: The study has been completed with educational interventions implemented and qualitative and quantitative data collected.
Interventions
BEHAVIORALEducational Intervention
The intervention consists of two (2) different types of training, both to be delivered through a train-the-trainer approach. The first of these is coaching-supervision training for nurse managers and other supervisory personnel in the CLC units. The second component is a one-day training for DCWs on communication and managing problem behaviors associated with dementia. These two trainings build on validated training models that have been developed by PHINational, but will be adapted and customized to include VA-developed clinical content on the management of problem behaviors associated with dementia.
Sponsors
US Department of Veterans Affairs
Study design
Allocation
NON_RANDOMIZED
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* VA Employees: psychologists, nurse-managers and front-line nursing care staff assigned to CLCs will be included
Exclusion criteria
* Those not working in the CLC, * Those working in the CLC but not involved in the training intervention that is the focus of the study (e.g. Environment Management Service personnel, dietary personnel)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Completion of Training Intervention | This outcome was assessed at the end of the 1 year pilot study. | This outcome measures the number of participants that fully completed the training intervention. |
| Facility Implementation of Trainings | This outcome was assessed at the end of the 1 year pilot study. | This measure assesses the number of participating facilities (4) that implemented trainings in their own facilities upon completion of our educational training intervention. |
| Number of Participants in Pilot Surveys | This outcome was assessed at the end of the 1 year pilot study. | This outcome measures the number of participants that completed the survey during the pilot in order to assess the feasibility of conducting a larger study. |
| Number of Participants in Pilot Interviews | This outcome was assessed at the end of the 1 year pilot study. | This outcome measures the number of participants that participated in interviews that were conducted during the pilot in order to assess the feasibility of conducting a larger study. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Training Feasibility 4 sites (8 individuals) received the training intervention to determine the feasibility of the train-the trainer approach.
The educational intervention is included in this arm. | 8 |
| Data Collection - Survey Survey data collection tools were piloted to assess feasibility of survey administration and development of the survey for future studies. These tools were piloted in sites where the educational intervention was administered. | 24 |
| Data Collection - Interview Interview data collection tools were piloted to assess feasibility of interview administration and development of the interview protocol for future studies. These tools were piloted in sites where the educational intervention was administered. | 13 |
| Total | 45 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Withdrawal by Subject | 1 | 0 | 0 |
Baseline characteristics
| Characteristic | Data Collection - Interview | Total | Training Feasibility | Data Collection - Survey |
|---|---|---|---|---|
| Age, Categorical <=18 years | NA Participants | NA Participants | NA Participants | NA Participants |
| Age, Categorical >=65 years | NA Participants | NA Participants | NA Participants | NA Participants |
| Age, Categorical Between 18 and 65 years | NA Participants | NA Participants | NA Participants | NA Participants |
| Race/Ethnicity, Customized American Indian/Alaskan Native | NA participants | NA participants | NA participants | 0 participants |
| Race/Ethnicity, Customized Asian | NA participants | NA participants | NA participants | 0 participants |
| Race/Ethnicity, Customized Black | NA participants | NA participants | NA participants | 5 participants |
| Race/Ethnicity, Customized Native Hawaiian/Other Pacific Islander | NA participants | NA participants | NA participants | 0 participants |
| Race/Ethnicity, Customized Unknown | NA participants | NA participants | NA participants | 2 participants |
| Race/Ethnicity, Customized White | NA participants | NA participants | NA participants | 17 participants |
| Sex/Gender, Customized Female | NA participants | NA participants | NA participants | 19 participants |
| Sex/Gender, Customized Male | NA participants | NA participants | NA participants | 4 participants |
| Sex/Gender, Customized Unknown | NA participants | NA participants | NA participants | 1 participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 0 / 0 | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 | 0 / 0 |
Outcome results
Primary
Completion of Training Intervention
This outcome measures the number of participants that fully completed the training intervention.
Time frame: This outcome was assessed at the end of the 1 year pilot study.
Population: The analysis population includes only participants who started the Train-the-Trainer intervention and therefore only participants in the Training Feasibility Arm/Group were analyzed for this outcome.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Training Feasibility | Completion of Training Intervention | 7 participants |
Primary
Facility Implementation of Trainings
This measure assesses the number of participating facilities (4) that implemented trainings in their own facilities upon completion of our educational training intervention.
Time frame: This outcome was assessed at the end of the 1 year pilot study.
Population: This unit of measure for this outcome measure is at the facility level. There were 4 facilities (8 trainees) in total that began the training intervention.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Training Feasibility | Facility Implementation of Trainings | Coaching and Supervision Training | 3 Facility |
| Training Feasibility | Facility Implementation of Trainings | Direct Care Worker Training | 2 Facility |
Primary
Number of Participants in Pilot Interviews
This outcome measures the number of participants that participated in interviews that were conducted during the pilot in order to assess the feasibility of conducting a larger study.
Time frame: This outcome was assessed at the end of the 1 year pilot study.
Population: Only participants in the Data Collection - Interview group were analyzed for this outcome. The population included trainees and direct care workers.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Data Collection - Interview | Number of Participants in Pilot Interviews | 13 participants |
Primary
Number of Participants in Pilot Surveys
This outcome measures the number of participants that completed the survey during the pilot in order to assess the feasibility of conducting a larger study.
Time frame: This outcome was assessed at the end of the 1 year pilot study.
Population: Only participants in the Data Collection - Survey group were analyzed for this outcome. The population included trainees and direct care workers.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Data Collection - Survey | Number of Participants in Pilot Surveys | 24 participants |