Improving caring quality for people with dementia in nursing homes using IPOS-Dem: A stepped-wedge cluster randomized controlled trial protocol

Frank Spichiger; Andrea L Koppitz; Susanne De Wolf-Linder; Fliss E M Murtagh; Thomas Volken; Philip Larkin

doi:10.1111/jan.14953

Improving caring quality for people with dementia in nursing homes using IPOS-Dem: A stepped-wedge cluster randomized controlled trial protocol

J Adv Nurs. 2021 Oct;77(10):4234-4245. doi: 10.1111/jan.14953. Epub 2021 Jul 7.

Authors

Frank Spichiger^{1

2}, Andrea L Koppitz¹, Susanne De Wolf-Linder^{3

4}, Fliss E M Murtagh^{5

6}, Thomas Volken⁷, Philip Larkin^{2

8}

Affiliations

¹ HES-SO ▪ University of Applied, Science and Arts of Western Switzerland, School of Health Sciences Fribourg, Fribourg, Switzerland.
² Faculty of Biology and Medicine, Institute of Nursing, UNIL, University of Lausanne, Lausanne, Switzerland.
³ ZHAW, Zurich University of Applied Science, School of Health Professions, Institute of Nursing, Winterthur, Switzerland.
⁴ University of Hull, Hull York Medical School, Wolfson Palliative Care Research Centre, Hull, UK.
⁵ University of Hull, Hull York Medical School, Hull, UK.
⁶ Hull University Teaching Hospitals NHS Trust, Wolfson Palliative Care Research Centre, Hull, UK.
⁷ ZHAW, Zurich University of Applied Science, School of Health Professions, Institute of Health Science, Winterthur, Switzerland.
⁸ CHUV, Lausanne University Hospital, Lausanne, Switzerland.

Abstract

Aims: We aim to evaluate the effectiveness of the Integrated Palliative Care Outcome Scale for people with dementia-based case studies to improve the caring quality for people with dementia in nursing homes by frontline staff and family members.

Background: Swiss nursing homes mostly care for people with dementia. This population is at high risk of receiving little to no palliation for their complex needs. The majority of Swiss frontline healthcare staff do not systematically report on the needs of their residents. Additionally, family members do not routinely participate in assessment processes.

Design: We will conduct a stepped-wedge cluster randomized trial of repeated assessment using the Integrated Palliative Care Outcome Scale for people with dementia (IPOS-Dem) and subsequent case studies. Clusters will consist of Swiss nursing homes randomly assigned to one of three sequential intervention time points.

Methods: The study population will consist of people with dementia living in nursing homes with and without specialized dementia care facilities. Over 16 months, staff working at the frontline and family members will assess the needs and concerns of people with dementia using IPOS-Dem. Depending on sequence allocation, facilitated case studies will start after 3, 6 or 9 months. The primary outcome will be caring quality measured by QUALIDEM. The secondary outcome will be symptoms and concerns, as indicated by the IPOS-Dem sum-score. The Zürich Ethics Committee approved the study in 2019 (2019-01847).

Impact: The results of this study will contribute to improving the effectiveness of person-centred care for people with dementia. Collaboration between healthcare staff and family members will be systematically developed and built upon thorough assessment using the IPOS-Dem and related case studies. The use of IPOS-Dem will offer all frontline staff a systematic approach to have an independent voice within the nursing process, regardless of their qualification or grade.

Keywords: caring; dementia; family; needs; nursing; nursing home; palliative care; quality of life.

Publication types

Clinical Trial Protocol

MeSH terms

Dementia*
Family
Humans
Nursing Homes
Palliative Care
Quality of Health Care
Randomized Controlled Trials as Topic

Grants and funding

PC 20/17/Schweizerische Akademie der Medizinischen Wissenschaften