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dc.contributor.authorSampson, Elizabeth L
dc.contributor.authorFeast, Alexandra
dc.contributor.authorBlighe, Alan
dc.contributor.authorFroggatt, Katherine
dc.contributor.authorHunter, Rachael; orcid: 0000-0002-7447-8934
dc.contributor.authorMarston, Louise
dc.contributor.authorMcCormack, Brendan
dc.contributor.authorNurock, Shirley
dc.contributor.authorPanca, Monica
dc.contributor.authorPowell, Catherine
dc.contributor.authorRait, Greta
dc.contributor.authorRobinson, Louise; orcid: 0000-0003-0209-2503
dc.contributor.authorWoodward-Carlton, Barbara
dc.contributor.authorYoung, John
dc.contributor.authorDowns, Murna
dc.identifierpubmed: 31133585
dc.identifierpii: bmjopen-2018-026510
dc.identifierdoi: 10.1136/bmjopen-2018-026510
dc.identifier.citationBMJ open, volume 9, issue 5, page e026510
dc.descriptionFrom PubMed via Jisc Publications Router
dc.descriptionPublication status: epublish
dc.description.abstractAcute hospital admission is distressing for care home residents. Ambulatory care sensitive conditions, such as respiratory and urinary tract infections, are conditions that can cause unplanned hospital admission but may have been avoidable with timely detection and intervention in the community. The Better Health in Residents in Care Homes (BHiRCH) programme has feasibility tested and will pilot a multicomponent intervention to reduce these avoidable hospital admissions. The BHiRCH intervention comprises an early warning tool for noting changes in resident health, a care pathway (clinical guidance and decision support system) and a structured method for communicating with primary care, adapted for use in the care home. We use practice development champions to support implementation and embed changes in care. Cluster randomised pilot trial to test study procedures and indicate whether a further definitive trial is warranted. Fourteen care homes with nursing (nursing homes) will be randomly allocated to intervention (delivered at nursing home level) or control groups. Two nurses from each home become Practice Development Champions trained to implement the intervention, supported by a practice development support group. Data will be collected for 3 months preintervention, monthly during the 12-month intervention and 1 month after. Individual-level data includes resident, care partner and staff demographics, resident functional status, service use and quality of life (for health economic analysis) and the extent to which staff perceive the organisation supports person centred care. System-level data includes primary and secondary health services contacts (ie, general practitioner and hospital admissions). Process evaluation assesses intervention acceptability, feasibility, fidelity, ease of implementation in practice and study procedures (ie, consent and recruitment rates). Approved by Research Ethics Committee and the UK Health Research Authority. Findings will be disseminated via academic and policy conferences, peer-reviewed publications and social media (eg, Twitter). ISRCTN74109734; Pre-results. [Abstract copyright: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.]
dc.sourceeissn: 2044-6055
dc.subjectgeriatric medicine
dc.subjectheart failure
dc.subjectprimary care
dc.subjectrespiratory infections
dc.subjecturinary tract infections
dc.titleEvidence-based intervention to reduce avoidable hospital admissions in care home residents (the Better Health in Residents in Care Homes (BHiRCH) study): protocol for a pilot cluster randomised trial.

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