Ignite Creation Date:
2024-05-05 @ 12:04 PM
Last Modification Date:
2024-10-26 @ 9:20 AM
Study NCT ID:
NCT00234286
Status:
COMPLETED
Last Update Posted:
2015-04-27
First Post:
2005-10-04
Brief Title:
Intervention to Improve Care at Lifes End
Sponsor:
US Department of Veterans Affairs
Organization:
VA Office of Research and Development
Study Overview
Official Title:
Intervention to Improve Care at Lifes End in VA Medical Centers
Status:
COMPLETED
Status Verified Date:
2015-04
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
BEACON
Brief Summary:
The BEACON trial Best Practices for End-of-Life Care for Our Nations Veterans was a six-site implementation study to evaluate a multi-component education-based intervention to improve the quality of end-of-life care provided in VA Medical Centers
Detailed Description:
The BEACON trial Best Practices for End-of-Life Care for Our Nations Veterans was a six-site real-world implementation trial of a multi-component education-based intervention to improve the quality of end-of-life care conducted in VA Medical Centers VAMCs
The primary aim was to evaluate the effectiveness of a multi-component intervention for improving processes of care provided in the last days of life in VAMCs The second aim was to conduct after-death interviews with next-of-kin and qualitative analysis of their perceptions of the care provided to the veteran and family
The multi-component intervention targeted VAMC inpatient providers including physician nursing and ancillary staff It consisted of preparatory site visits a staff training program a newly developed Comfort Care order set decision support tool built into the CPRS and follow-up consultation The intervention team travelled to each site to conduct two weeks of comprehensive in-service training Staff were trained to identify actively-dying patients and implement a set of best practices of traditionally home-based hospice care for dying patients The team provided assistance with policies procedures and skill training needed to implement comfort care interventions Introduction of the intervention at each VAMC was staggered across time at six-month intervals using a multiple-baseline stepped wedge design
Data on processes of end-of-life care last 7 days were abstracted from the CPRS medical records of all veterans who died before during and after the intervention January 2005-February 2011 A priori five processes of care were identified as primary endpoints to indicate quality of end-of-life care 1 presence of an order for opioid pain medication at time of death 2 a do-not-resuscitate DNR order in place at time of death 3 location of death 4 presence of enteral feeding tube or intravenous line at time of death and 5 physical restraints in place at or near time of death
In addition in-depth face-to-face interviews were conducted with 78 bereaved next-of-kin
The primary aim was to evaluate the effectiveness of a multi-component intervention for improving processes of care provided in the last days of life in VAMCs The second aim was to conduct after-death interviews with next-of-kin and qualitative analysis of their perceptions of the care provided to the veteran and family
The multi-component intervention targeted VAMC inpatient providers including physician nursing and ancillary staff It consisted of preparatory site visits a staff training program a newly developed Comfort Care order set decision support tool built into the CPRS and follow-up consultation The intervention team travelled to each site to conduct two weeks of comprehensive in-service training Staff were trained to identify actively-dying patients and implement a set of best practices of traditionally home-based hospice care for dying patients The team provided assistance with policies procedures and skill training needed to implement comfort care interventions Introduction of the intervention at each VAMC was staggered across time at six-month intervals using a multiple-baseline stepped wedge design
Data on processes of end-of-life care last 7 days were abstracted from the CPRS medical records of all veterans who died before during and after the intervention January 2005-February 2011 A priori five processes of care were identified as primary endpoints to indicate quality of end-of-life care 1 presence of an order for opioid pain medication at time of death 2 a do-not-resuscitate DNR order in place at time of death 3 location of death 4 presence of enteral feeding tube or intravenous line at time of death and 5 physical restraints in place at or near time of death
In addition in-depth face-to-face interviews were conducted with 78 bereaved next-of-kin
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None