Viewing Study NCT00120068


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Study NCT ID: NCT00120068
Status: COMPLETED
Last Update Posted: 2015-04-07
First Post: 2005-07-01
Is NOT Gene Therapy: False
Has Adverse Events: False

Brief Title: Improving Care for Nursing Home Pneumonia in NHCUs and Veterans' Homes
Sponsor: US Department of Veterans Affairs
Organization:

Study Overview

Official Title: Improving Care for Nursing Home Pneumonia in NHCUs and Veterans' Homes
Status: COMPLETED
Status Verified Date: 2007-02
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: None
Brief Summary: Nursing Home Acquired Pneumonia (NHAP) causes excessive morbidity, mortality, hospitalization, and loss of function. At any given time, 1.1-2.5% of veterans who reside at nursing home care units (NHCUs) and State Veterans Homes (SVHs) are ill with pneumonia. Multi-faceted implementation of evidence-based guidelines has been shown to be feasible in the private sector. Retrospective studies demonstrate an association between guideline adherence and improved survival.
Detailed Description: Background:

Nursing Home Acquired Pneumonia (NHAP) causes excessive morbidity, mortality, hospitalization, and loss of function. At any given time, 1.1-2.5% of veterans who reside at nursing home care units (NHCUs) and State Veterans Homes (SVHs) are ill with pneumonia. Multi-faceted implementation of evidence-based guidelines has been shown to be feasible in the private sector. Retrospective studies demonstrate an association between guideline adherence and improved survival.

Objectives:

Assess the feasibility of a QUERI-like strategy to translate the guidelines into practice at VA-affiliated nursing homes through focus groups, interviews, and a small intervention trial.

Methods:

Nursing staff focus groups, key informant interviews, and tests of academic detailing (educational outreach) scripts were conducted at five facilities. Based on the information gathered, the QUERI-like intervention was modified and tested at the Florence, Colorado SVH during one influenza season compared to no intervention at a nearby SVH. Forty random SVH nursing staff took an anonymous telephone survey of knowledge and attitudes about NHAP twice prior to the intervention. A second randomly selected group of CNAs and nurses took the survey after the intervention. Research assistants enrolled residents with NHAP, interviewed them and their nurses about their quality of life, assessed their function and reviewed their medical records. The intervention was multifaceted, including (1) a formative phase to tailor implementation and foster staff investment in process and outcomes, (2) institutional level change to facilitate immunization and use of appropriate antibiotics and tests; (3) interactive educational sessions to improve nursing assessment; and (4) academic detailing to physicians to impact diagnostic and prescribing practices. Data were analyzed by Template Analysis Technique for qualitative data; test-retest reliability of the knowledge and attitude survey; exploratory bivariate comparison of intervention delivery and uptake, process of care and outcomes between the intervention and control facilities.

Status:

Project work is ongoing.

Study Oversight

Has Oversight DMC: False
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?: