TY - JOUR A1 - Klingshirn, Hanna A1 - Müller, Martin A1 - Beutner, Katrin A1 - Hirt, Julian A1 - Strobl, Ralf A1 - Grill, Eva A1 - Meyer, Gabriele A1 - Saal, Susanne T1 - Implementation of a complex intervention to improve participation in older people with joint contractures living in nursing homes: a process evaluation of a cluster-randomised pilot trial JF - BMC Geriatrics N2 - Background Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation. Methods The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis. Results Seven nursing homes (n = 4 intervention groups, n = 3 control groups) in two regions of Germany took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: “good”; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nurses. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers. Conclusion The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning are needed to support the facilitators during implementation in the main trial. Trial registration German clinical trials register, DRKS00010037. Registered 12 February 2016. KW - Joint contractures KW - Nursing homes KW - Participation KW - Complex intervention KW - Cluster-randomised controlled trials KW - Pilot study KW - Implementation strategy KW - Process evaluation Y1 - 2020 UR - https://doi.org/10.1186/s12877-020-01655-z VL - 20 SP - 270 ER - TY - GEN A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Herausforderungen und Versorgungsstrategien im Kontext von Pflegeheimeinzügen in Deutschland: Ein Scoping Review. Poster für den EbM-Kongress vom 22.-24. März 2023 in Potsdam KW - Pflegeheimeinzug Y1 - 2023 ER - TY - GEN A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Challenges and care strategies during the transition to nursing home in Germany: A scoping review. European Nursing Kongress am 5. Oktober 2022, online KW - transition to nursing home Y1 - 2022 ER - TY - JOUR A1 - Skudlik, Stefanie A1 - Hirt, Julian A1 - Döringer, Tobias A1 - Thalhammer, Regina A1 - Lüftl, Katharina A1 - Prodinger, Birgit A1 - Müller, Martin T1 - Challenges and care strategies associated with the admission to nursing homes in Germany: a scoping review JF - BMC Nursing N2 - Background The admission to a nursing home is a critical life-event for affected persons as well as their families. Admission related processes are lacking adequate participation of older people and their families. To improve transitions to nursing homes, context- and country-specific knowledge about the current practice is needed. Hence, our aim was to summarize available evidence on challenges and care strategies associated with the admission to nursing homes in Germany. Methods We conducted a scoping review and searched eight major international and German-specific electronic databases for journal articles and grey literature published in German or English language since 1995. Further inclusion criteria were focus on challenges or care strategies in the context of nursing home admissions of older persons and comprehensive and replicable information on methods and results. Posters, only-abstract publications and articles dealing with mixed populations including younger adults were excluded. Challenges and care strategies were identified and analysed by structured content analysis using the TRANSCIT model. Results Twelve studies of 1,384 records were finally included. Among those, seven were qualitative studies, three quantitative observational studies and two mixed methods studies. As major challenges neglected participation of older people, psychosocial burden among family caregivers, inadequate professional cooperation and a lack of shared decision-making and evidence-based practice were identified. Identified care strategies included strengthening shared decision-making and evidence-based practice, improvement in professional cooperation, introduction of specialized transitional care staff and enabling participation for older people. Conclusion Although the process of nursing home admission is considered challenging and tends to neglect the needs of older people, little research is available for the German health care system. The perspective of the older people seems to be underrepresented, as most of the studies focused on caregivers and health professionals. Reported care strategies addressed important challenges, however, these were not developed and evaluated in a comprehensive and systematic way. Future research is needed to examine perspectives of all the involved groups to gain a comprehensive picture of the needs and challenges. Interventions based on existing care strategies should be systematically developed and evaluated to provide the basis of adequate support for older persons and their informal caregivers. KW - transition to nursing home Y1 - 2023 U6 - https://doi.org/10.1186/s12912-022-01139-y VL - 22 ER -