Improving Detection of Client Complexity in the Community (Impact): A Study Protocol of a Pragmatic Randomized Controlled Trial
Abstract
:1. Introduction
1.1. Global Ageing Population and the Implications
1.2. Ageing Population in Australia and the Implications
1.3. Factors Contributing to Complexity
1.4. Assessment of Older People by Nurses
1.5. Aim and Objectives
2. Methods
2.1. Study Design
2.2. Setting and Participants
2.3. Inclusion Criteria
2.4. Exclusion Criteria
2.5. Intervention
2.6. Sample Size
2.7. Randomization
2.8. Study Procedures
2.9. Outcomes
2.10. Data Analysis
2.11. Data Storage and Handling
3. Expected Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Age UK. NHS Continuing Healthcare. 2020. Available online: https://www.ageuk.org.uk/information-advice/health-wellbeing/health-services/nhs-continuing-healthcare/ (accessed on 2 March 2021).
- Australian Institute of Health and Welfare. Australia’s Health 2018. In AUS 221; Australian Institute of Health and Welfare (AIHW): Canberra, Australia, 2018. [Google Scholar]
- Australia Government. Ageing and Aged Care, Department of Health. Canberra; 2019. Available online: https://agedcare.health.gov.au/aged-care-reform (accessed on 4 February 2021).
- Australian College of Nursing (ACN). The Importance of Value-Based Health Care to Patient-Centred, Fiscally Responsible Health Care and the Centrality of Nursing to Its Authentic and Effective Functioning; Australian College of Nursing (ACN): Canberra, Australia, 2020; ISBN 978-1-925913-53-8. [Google Scholar]
- Australian Government. Health Assessment for People Aged 75 Years and Older Fact Sheet. 2015. Available online: https://www1.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_mbsitem_75andolder (accessed on 24 August 2021).
- Australian Government. Australian Burden of Disease Study: Impact and Causes of Illness and Death in Australia 2011. AIHW: Canberra, Australia, 2016. Available online: https://www.aihw.gov.au/reports/burden-of-disease/abds-impact-and-causes-of-illness-death-2011 (accessed on 8 July 2019).
- Australian Government. My Aged Care-National Screening and Assessment form User Guide. 2018. Available online: https://www.health.gov.au/resources/publications/my-aged-care-national-screening-and-assessment-form-user-guide (accessed on 8 July 2021).
- Australian Government. 2020–2025 National Health Reform Agreement (NHRA). Canberra; 2020. Available online: https://www.health.gov.au/initiatives-and-programs/2020-25-national-health-reform-agreement-nhra (accessed on 2 February 2021).
- Australian Government. Australian Institute of Health and Welfare 2020. Australia’s Health 2020 Data Insights. 2020. Available online: https://www.aihw.gov.au/reports/australias-health/australias-health-2020-data-insights/contents/summary (accessed on 2 February 2021).
- Australian Government. Older Australia at a Glance. (Cat. No: AGE 87). 2021. Available online: https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/summary (accessed on 7 September 2021).
- Baldwin, M. The Warrington workload tool: Determining its use in one trust. Br. J. Community Nurs. 2006, 11, 391–395. [Google Scholar] [CrossRef]
- Bauer, M.; Fitzgerald, L.; Haesler, E.; Manfrin, M. Hospital discharge planning for frail older people and their family. Are we delivering best practice? A review of the evidence. J. Clin. Nurs. 2009, 18, 2539–2546. [Google Scholar] [CrossRef]
- Braun, V.; Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101. [Google Scholar] [CrossRef] [Green Version]
- Briggs, L.A. Royal Commission into Aged Care Quality and Safety Interim Report: Neglect. 2019. Available online: https://agedcare.royalcommission.gov.au/publications/Documents/interim-report/interim-report-volume-1.pdf (accessed on 20 February 2020).
- Britt, H.C.; Harrison, C.M.; Miller, G.C.; Know, S.A. Prevalence and patterns of multimorbidity in Australia. Med. J. Aust. 2008, 189, 72–76. [Google Scholar] [CrossRef]
- Burgess, S.; Hercus, C. Frailty in Community Dwelling Older People-Using Frailty Screening as the Canary in the Coal Mine. 2017. Available online: https://www.benetas.com.au/assets/documents/Frailty-Report-abridged.pdf (accessed on 25 March 2021).
- Canadian Institute for Health Information. Common Challenges, Shared priorities: Measuring Access to Home and Community Care and to Mental Health and Addictions Services in Canada. Ottawa. 2019. Available online: https://www.cihi.ca/sites/default/files/document/shp-companion-report-en.pdf (accessed on 1 March 2021).
- Canadian Institute for Health Information. Inter RAI Toolkit. 2021. Available online: https://www.cihi.ca/en/interrai-implementation-toolkit/get-started/choose-your-assessors (accessed on 2 September 2021).
- Capezuti, E.; Hamers, J.P.H. Perspectives on how to improve the nursing care of older adults. Int. J. Nurs. Stud. 2013, 50, 1153–1155. [Google Scholar] [CrossRef] [PubMed]
- Chalk, D.; Legg, A. What factors are driving increasing demand for community nursing? Br. J. Community Nurs. 2017, 22, 675–681. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Commonwealth of Australia. Commonwealth Home Support Program-Program Manual, Department of Health. 2018. Available online: https://creativecommons.org/licenses/by/4.0/legalcode (accessed on 2 February 2020).
- de Souza Orlandi, F.; Brochine Lanzotti, R.; Gomes Duarte, J.; Novais Mansur, H.; Zazzetta, M.S.; Iost Pavarini, S.C.; Matumoto, S. Translation, Adaptation and Validation of Rapid Geriatric Assessment to the Brazilian Context. J. Nutr. Health Aging 2018, 22, 1115–1121. [Google Scholar] [CrossRef]
- Department of Health & Human Services. Nation Health Reform Agreement. 2011. Available online: https://www2.health.vic.gov.au/about/publications/policiesandguidelines/national-health-reform-agreement-2011 (accessed on 7 February 2021).
- Efird, J. Block Randomised with Randomly Selected Block Sizes. Int. J. Environ. Res. Public Health 2011, 8, 15–20. [Google Scholar] [CrossRef] [Green Version]
- Gobbens, R.J.; Boersma, P.; Uchmanowicz, I.; Santiago, L.M. The Tilburg Frailty Indicator (TFI): New Evidence for Its Validity. Clin. Interv. Aging 2021, 15, 265–274. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gobbens, R.J.; Luijkx, K.G.; Wijnen-Sponselee, M.T.; Schols, J.M. Toward a conceptual definition of frail community dwelling older people. Nurs. Outlook 2010, 58, 76–86. [Google Scholar] [CrossRef]
- Huber, E.; Kleinknecht-Dolf, M.; Kugler, C.; Müller, M.; Spirig, R. Validation of the instrument “Complexity of Nursing Care”—A mixed-methods study. Nurs. Open 2020, 7, 212–224. [Google Scholar] [CrossRef] [PubMed]
- Huynh, E.; Basic, D.; Gonzales, R.; Shanley, C. Structured interdisciplinary bedside rounds do not reduce length of hospital stay and 28-day re-admission rate among older people hospitalised with acute illness: An Australian study. Aust. Health Rev. 2017, 41, 599–605. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kirby, E.; Hurst, K. Using a complex audit tool to measure workload, staffing and quality in district nursing. Br. J. Community Nurs. 2014, 19, 219–223. [Google Scholar] [CrossRef] [PubMed]
- Lau, J.Y.-C.; Wong, E.L.-Y.; Chung, R.Y.; Law, S.C.K.; Threapleton, D.; Kiang, N.; Yeoh, E.-K. Collaborate across silos: Perceived barriers to integration of care for the elderly from the perspectives of service providers. Int. J. Health Plan. Manag. 2018, 33, e768–e780. [Google Scholar] [CrossRef]
- Leon, A.; Davis, L.; Kraemer, H. The role and interpretation of pilot studies in clinical research. J. Psychiatr. Res. 2010, 45, 626–629. [Google Scholar] [CrossRef] [Green Version]
- Liu, Y.-E.; Norman, I.J.; While, A.E. Nurses’ attitudes towards older people: A systematic review. Int. J. Nurs. Stud. 2013, 50, 1271–1282. [Google Scholar] [CrossRef]
- Luker, K.A. Challenges for home care nurses in providing quality care. Prim. Health Care Res. Dev. 2006, 7, 291–298. [Google Scholar] [CrossRef] [Green Version]
- McGeorge, S.J. Unravelling the differences between complexity and frailty in old age: Findings from a constructivist grounded theory study. J. Psychiatr. Ment. Health Nurs. 2011, 18, 67–73. [Google Scholar] [CrossRef]
- McIntosh, J. The evidence base for individual patient and client assessment by community nurses. Prim. Health Care Res. Dev. 2006, 7, 299–308. [Google Scholar] [CrossRef]
- McKenna, H. Intergrating Care: Next Steps to Building Strong and Effective Integrated Care Systems across England. 2011. Available online: https://www.kingsfund.org.uk/publications/health-social-care-white-paper-explained (accessed on 13 August 2021).
- Metzelthin, S.F.; Daniëls, R.; van Rossum, E.; Cox, K.; Habets, H.; de Witte, L.P.; Kempen, G.I.J.M. A nurse-led interdisciplinary primary care approach to prevent disability among community-dwelling frail older people: A large-scale process evaluation. Int. J. Nurs. Stud. 2013, 50, 1184–1196. [Google Scholar] [CrossRef]
- Moher, D.; Hopewell, S.; Schulz, K.; Montori, V.; Gotszsche, P.; Devereaux, P.; Altman, D. Consort 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trial. BMJ 2010, 340, c869. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Moore, C.; Carter, R.; Niertert, P.; Stewart, P. Recommendations for Planning Pilot Studies in Clinical and Translational Research. Clin. Transl. Sci. 2011, 4, 332–337. [Google Scholar] [CrossRef] [PubMed]
- Rietkerk, W.; Smit, M.F.; Wynia, K.; Slaets, J.P.J.; Zuidema, S.U.; Gerritsen, D.L. Explaining experiences of community-dwelling older adults with a pro-active comprehensive geriatric assessment program—A thorough evaluation by interviews. BMC Geriatr. 2019, 19, 12. [Google Scholar] [CrossRef] [PubMed]
- Royal Commission. Final Report: Care, Dignity and Respect. Available online: https://agedcare.royalcommission.gov.au/sites/default/files/2021-03/final-report-volume-1_0.pdf (accessed on 7 August 2021).
- Thomas, S. Patient Complexity: Conceptualisation, Development and Validation of an Assessment Instrument for District Nurses. Ph.D. Thesis, University of South Wales/Prifysgol De Cymru, Wales, UK, March 2017. [Google Scholar]
- Van Rijn, M.; Suijker, J.J.; Wietske, B.O.L.; Hoff, E.V.A.; Gerben Ter, R.; De Rooij, S.E.; Buurman, B.M. Comprehensive geriatric assessment: Recognition of identified geriatric conditions by community-dwelling older persons. Age Ageing 2016, 45, 891–899. [Google Scholar] [CrossRef] [Green Version]
- Winterton, R.; Bramble, M. A decade of rural ageing research in the Australasian Journal on Ageing. Australas. J. Ageing 2021, 40, 12–15. [Google Scholar] [CrossRef]
- World Health Organization. World Report on Ageing and Health, World Health Organization. Geneva. 2015. Available online: https://www.who.int/ageing/publications/world-report-2015/en/ (accessed on 7 July 2019).
- World Health Organization. Integrated Care for Older People Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity. World Health Organization, 2017. Available online: https://www.who.int/ageing/publications/guidelines-icope/en/ (accessed on 7 July 2019).
- World Health Organization. Integrated Care for Older People (ICOPE): Guidance for Person-Centred Assessment and Pathways in Primary Care. World Health Organization: Geneva, Switzerland, 2019. Available online: https://www.who.int/ageing/health-systems/en/ (accessed on 14 August 2020).
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Boak, J.; Blackberry, I.; Rasekaba, T. Improving Detection of Client Complexity in the Community (Impact): A Study Protocol of a Pragmatic Randomized Controlled Trial. Methods Protoc. 2021, 4, 70. https://doi.org/10.3390/mps4040070
Boak J, Blackberry I, Rasekaba T. Improving Detection of Client Complexity in the Community (Impact): A Study Protocol of a Pragmatic Randomized Controlled Trial. Methods and Protocols. 2021; 4(4):70. https://doi.org/10.3390/mps4040070
Chicago/Turabian StyleBoak, Jennifer, Irene Blackberry, and Tshepo Rasekaba. 2021. "Improving Detection of Client Complexity in the Community (Impact): A Study Protocol of a Pragmatic Randomized Controlled Trial" Methods and Protocols 4, no. 4: 70. https://doi.org/10.3390/mps4040070