Dissemination and Implementation of Function Focused Care for Assisted Living

传播和实施以功能为中心的辅助生活护理

• 批准号: 9103803
• 负责人: BARBARA RESNICK
• 金额: $ 32.88万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9103803
• 关键词: Activities of Daily Living; Acute; Adoption; Adverse event; Assisted Living Facilities; Belief; Care given by nurses; Caregivers; Caring; Cognitive; Cost utility; Data; Decubitus ulcer; Discipline of Nursing; Disease Progression; Education; Effectiveness; Elderly; Environment; Evaluation; Event; Evidence based intervention; Family; Family Caregiver; Focus Groups; Fright; Goals; Healthcare Systems; Hospitalization; Hospitals; Hour; Individual; Intervention; Knowledge; Length of Stay; Long-Term Care; Maintenance; Maryland; Massachusetts; Measures; Medication Management; Mentors; Methods; Modeling; Nurses; Nursing Homes; Nursing Research; Outcome; Pain; Pennsylvania; Physical activity; Policies; Preparation; Process; Quality of life; Randomized; Randomized Controlled Trials; Research; Resources; Services; Testing; Time; Training; Translations; Treatment Efficacy; Work; base; caregiving; cost; dissemination trial; effective intervention; efficacy trial; evidence base; experience; fall risk; falls; functional decline; implementation trial; improved; improved functioning; instrumental activity of daily living; multiple chronic conditions; prevent; public health relevance; sedentary; social; social cognitive theory; theories; volunteer

 DESCRIPTION (provided by applicant): Assisted living (AL) settings provide homelike environments for individuals who need help with activities of daily living (ADL) or instrumental ADLs (e.g., medication management) but for whom 24-hour nursing care is not necessary. Nearly 40% of residents in AL settings require assistance with three or more ADLs and most need help with meal preparation and medication management. They tend to experience even more functional decline and spend less time in physical activity than residents in nursing facilities. This decline is not completely related to disease progression. Rather, it is due to the way care is provided and the tendency caregivers have to perform the care task for the resident rather than allowing him or her to do the activity. In addition, there is an excessive fear among older adults, families and caregivers that engaging in physical activity will result in adverse events (e.g., falls). The persistent decrease in function and physical activity in residents actualy increases their risk for falls, pain, pressure ulcers, further functional decline, hospitalizations nursing home placement, and decreases quality of life. Function Focused Care for AL (FFC-AL) is an approach to care such that residents are helped to participate in functional and physical activity throughout the course of the day. FFC-AL is a four-step theory-based approach including: (1) Environment and Policy Assessments; (2) Education; (3) Establishing Resident Service Plans; and (4) Mentoring and Motivating Direct Care Workers and Residents. In efficacy trials, FFC-AL was implemented over 12 months by a Research Nurse Facilitator working with an identified setting champion. Residents in settings exposed to FFC-AL maintained or improved function, spent more time in physical activity and were less likely to be transferred to acute care facilities. Unfortunately, implementing effective care approaches like FFC-AL into AL settings is challenging due to setting and resident related factors. To overcome these challenges we developed a theory based approach using Social Cognitive Theory, the Social Ecological Model and the Evidence Integration Triangle (EIT). This approach, referred to as FFC-AL-EIT, includes the involvement of setting stakeholders, uses resources currently available in AL settings and allows for an individualized focus on setting specific challenges. This study will test the dissemination and implementation of FFC-AL-EIT across 96 AL settings in Maryland, Pennsylvania and Massachusetts and will include 960 residents. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) model will be used to evaluate outcomes. By using a theory based approach and building off prior experience in disseminating and implementing function focused care, this study will add to what is known about dissemination and implementation of effective interventions in AL settings and serve as a model for other care approaches.

 描述（通过申请提供）：辅助生活（AL）设置为个人生活（ADL）或仪器ADL提供了居家般的环境（例如，药物管理），但对于三个环境，对于三个环境而言，对于三个设置而言。或更多的ADL和大多数人在饮食中的帮助和药物管理往往会出现更多的功能下降，而在体育锻炼上的时间比居民在护理设施中的时间更少。 提供方式护理和趋势护理任务比允许他的任务，老年人，家庭和护理人员的恐惧过多，从事体育锻炼会导致不良事件（例如，跌倒）。居民的活动增加了风险下降，压力溃疡，进一步的功能下降，护理护理家庭安置以及降低生活质量（FFC-AL）是一种护理的方法。这一天。 FFC-AL是由研究护士协助的12个月来与确定的环境冠军一起工作的。由于环境和居民的相关因素，我们正在使用社会认知理论的化合物模型和证据整合三角形（EIT），这是由于挑战而引起的。设定利益相关者的参与使用AL中目前可用的资源。该研究将用于评估ACH并建立传播和实施重点护理方面的先前经验，这将增加有关传播和倾斜的知识，并像其他护理中一样充当Amodel。