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Nursing Discharge Teaching for Multimorbid Inpatients

NCT ID: NCT04253665

Last Updated: 2021-11-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

225 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-13

Study Completion Date

2021-09-30

Brief Summary

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The objective of this study is to estimate the effect size of a nursing discharge teaching intervention on multimorbid inpatients activation level, health confidence, readiness for hospital discharge, experience with discharge care and rate and time to 7-days readmission.

Detailed Description

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Seniors returning home from hospital have to manage several chronic conditions in addition to their daily tasks. The teaching provided by nurses during hospitalization is essential care to prepare them to manage their health at home. Nevertheless, there is often a gap between professionals' belief that the teaching they have provided to patients has met their needs, and patients' perceptions of the relevance of the teaching content to their home situation. The time available to conduct this teaching is also short during the hospital stay and there is limited knowledge about how to adapt this teaching for patients who must manage multiple chronic conditions at the same time. Thus, there is a real need to develop and test a new teaching nursing intervention to prepare for the return home that takes into account the unique and complex needs and characteristics of patients with multiple chronic conditions. Tailoring teaching to seniors' life situation and level of activation (i.e., knowledge, skills and confidence in managing their health) would best meet the needs of these patients for managing their health at home. An intervention that takes these characteristics into account has been developed and will be tested in this study.

Conditions

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Chronic Disease

Keywords

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Discharge teaching Nursing Multimorbidity

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

2 group pre/post-intervention comparative design: 90 control patients will be recruited before the implementation of the intervention in study units. This recruitment will last approximately two months, according to the estimated turnout of patients in these units. After this control period, 30 other patients will be recruited to receive the intervention. In this sense, participants are assigned to one group or the other, depending on the phase of the study.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Usual care

Discharge teaching is usually not delivered in a systematic or consistenly way, nor by relying on a particular intervention model.

Group Type NO_INTERVENTION

No interventions assigned to this group

Discharge teaching

Receiving tailored discharge teaching by nurses during hospital stay.

Group Type EXPERIMENTAL

Nursing discharge teaching

Intervention Type BEHAVIORAL

Nurses will provide multimorbid seniors inpatients with teaching related to self-management to prepare them to be discharged home. The teaching delivery will be tailored to patients' activation level and priorities. The intervention begins by determining the level of activation at which patients are and identifying priorities to address related to patients' life situation. A Discharge Teaching Guide will be used by nurses to deliver the teaching and includes six domains of self-management. For each domain, nurses first report whether a priority has been identified and what intervention they have proposed to address it. Then for each domain, teaching objectives are described and differ according to the level of patient activation. These six domains of self-management are found in the patient-oriented discharge summary, which is a document for the patient that summarizes what has been addressed in discharge teaching.

Interventions

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Nursing discharge teaching

Nurses will provide multimorbid seniors inpatients with teaching related to self-management to prepare them to be discharged home. The teaching delivery will be tailored to patients' activation level and priorities. The intervention begins by determining the level of activation at which patients are and identifying priorities to address related to patients' life situation. A Discharge Teaching Guide will be used by nurses to deliver the teaching and includes six domains of self-management. For each domain, nurses first report whether a priority has been identified and what intervention they have proposed to address it. Then for each domain, teaching objectives are described and differ according to the level of patient activation. These six domains of self-management are found in the patient-oriented discharge summary, which is a document for the patient that summarizes what has been addressed in discharge teaching.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* 2 chronic diseases or more
* Being discharged home
* Able to speak, read and write in French

Exclusion Criteria

* Insufficient capacity to consent assessed with the University of California San Diego Brief Assessment of Capacity to Consent (UBACC).
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Lausanne

OTHER

Sponsor Role lead

Responsible Party

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Dr. Sc. Cedric Mabire, RN PhD

Dr.Sc.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Cedric Mabire, Dr. Sc.

Role: PRINCIPAL_INVESTIGATOR

Institute of Higher Education and Research in Healthcare, University of Lausanne

Locations

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Lausanne University Hospital (CHUV)

Lausanne, , Switzerland

Site Status

EHC (Hôpital de Morges)

Morges, , Switzerland

Site Status

eHnv (Etablissements hospitaliers du nord vaudois)

Yverdon-les-Bains, , Switzerland

Site Status

Countries

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Switzerland

References

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Pellet J, Weiss M, Mabire C. Evaluation of a theory-informed implementation of a nursing discharge teaching intervention for older adults. J Adv Nurs. 2023 Aug;79(8):3147-3159. doi: 10.1111/jan.15666. Epub 2023 Apr 4.

Reference Type DERIVED
PMID: 37014070 (View on PubMed)

Pellet J, Weiss M, Zuniga F, Mabire C. Implementation and preliminary testing of a theory-guided nursing discharge teaching intervention for adult inpatients aged 50 and over with multimorbidity: a pragmatic feasibility study protocol. Pilot Feasibility Stud. 2021 Mar 17;7(1):71. doi: 10.1186/s40814-021-00812-4.

Reference Type DERIVED
PMID: 33731212 (View on PubMed)

Other Identifiers

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2020_2201

Identifier Type: -

Identifier Source: org_study_id