A Pilot Study of an RCT to Improve Infection Management in Advanced Dementia
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 4/21/2016 |
| Start Date: | October 2013 |
| End Date: | February 2016 |
To conduct a pilot study of cluster randomized clinical trial of an practice intervention to
improve the quality of care for suspected lower respiratory and and urinary tract infections
among 60 nursing home residents with advanced dementia living in 4 facilities (2 matched
intervention/control pairs) for 12 months. We hypothesize that 1. In the intervention
compared to the control facilities there will be a trend towards a greater proportion of
infections for which antimicrobials were initiated appropriately, and 2. in the intervention
compared to the control facilities there will be a trend towards higher proxy satisfaction
with decision-making, fewer hospital transfers, and lower antimicrobial exposure.
improve the quality of care for suspected lower respiratory and and urinary tract infections
among 60 nursing home residents with advanced dementia living in 4 facilities (2 matched
intervention/control pairs) for 12 months. We hypothesize that 1. In the intervention
compared to the control facilities there will be a trend towards a greater proportion of
infections for which antimicrobials were initiated appropriately, and 2. in the intervention
compared to the control facilities there will be a trend towards higher proxy satisfaction
with decision-making, fewer hospital transfers, and lower antimicrobial exposure.
Inclusion Criteria:
Resident eligibility criteria include: 1) Age > 65, 2) Dementia, 3) Global Deterioration
Scale score of 7,59 and 4) a proxy is available who can speak in English. Features of
Global deterioration stage 7 include: profound memory deficits (cannot recognize family),
total functional dependence, speech < 5 words, incontinence, and inability to ambulate.
Eligibility criteria for providers in the intervention nursing homes include: Medical
Doctor,a. nurse, nurse practitioner, physician assistant identified by a senior
administrator as an individual who cares for residents with advanced dementia, and is 2.
able to communicate in English because on-line course and algorithms are in English., and
3. over 21 years of age.
Exclusion Criteria:
Residents with cognitive impairment due to causes other than dementia (e.g., head trauma)
and in short-term, sub-acute SNFs will be excluded. -
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