scholarly journals Behavioural activation in nursing homes to treat depression (BAN-Dep): study protocol for a pragmatic randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032421 ◽  
Author(s):  
Diana Velasquez Reyes ◽  
Hema Patel ◽  
Nicola Lautenschlager ◽  
Andrew H Ford ◽  
Eleanor Curran ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Controlled Trial ◽  
Aged Care ◽  
Residential Aged Care ◽  
Behavioural Activation ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Randomised Controlled

IntroductionDepression is a common disorder among older people living in residential aged care facilities. Several trials have demonstrated the effectiveness of behavioural therapies in treating depressive symptoms in older adults living in the community and in residential aged care. Behavioural Activation is demonstrably effective even when delivered by non-specialists (staff without formal psychological training), although strategies for adapting its use in residential aged care facilities are yet to be explored. This study will determine whether training residential care staff in the use of a structured Behavioural Activation programme is more effective at decreasing depressive symptoms among older residents than internet-based training about depression recognition and management alone.Method and analysisThe behavioural activation in nursing homes to treat depression (BAN-Dep) trial is a pragmatic two-arm parallel clustered randomised controlled trial. It will recruit 666 residents aged 60 or older from 100 residential aged care facilities, which will be randomly assigned to the Behavioural Activation or control intervention. Staff in both treatment groups will be encouraged to complete theBeyondblueProfessional Education to Aged Care e-learning programme to improve their recognition of and ability to respond to depression in older adults. Selected staff from intervention facilities will undergo additional training to deliver an 8-module Behavioural Activation programme to residents with subthreshold symptoms of depression-they will receive ongoing Mental support from trained Behavioural Activation therapists. Outcome measures will be collected by blind research officer at baseline and after 3, 6 and 12 months. The Patient Health Questionnaire-9 is the primary outcome measure of the study.Ethics and disseminationThe trial will comply with the principles of the Declaration of Helsinki for Human Rights and is overseen by the University of Western Australia (reference RA/4/20/4234) and Melbourne Health (reference number HREC/18/MH/47) Ethics Committees. The results of this research project will be disseminated through publications and/or presentations in a variety of media to health professionals, academics, clinicians and the public. Only de-identified group data will be presented.Trial registrationACTRN12618000634279.

scholarly journals Multicentre stepped-wedge cluster randomised controlled trial of an antimicrobial stewardship programme in residential aged care: protocol for the START trial

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046142
Author(s):  
Natali Jokanovic ◽  
Terry Haines ◽  
Allen C Cheng ◽  
Kathryn E Holt ◽  
Sarah N Hilmer ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Aged Care ◽  
Residential Aged Care ◽  
Stepped Wedge ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Start Trial ◽  
Randomised Controlled ◽  
Tract Infections

IntroductionAntimicrobial resistance is a growing global health threat, driven by increasing inappropriate use of antimicrobials. High prevalence of unnecessary use of antimicrobials in residential aged care facilities (RACFs) has driven demand for the development and implementation of antimicrobial stewardship (AMS) programmes. The Stepped-wedge Trial to increase antibiotic Appropriateness in Residential aged care facilities and model Transmission of antimicrobial resistance (START) will implement and evaluate the impact of a nurse-led AMS programme on antimicrobial use in 12 RACFs.Methods and analysisThe START trial will implement and evaluate a nurse-led AMS programme via a stepped-wedge cluster randomised controlled trial design in 12 RACFs over 16 months. The AMS programme will incorporate education, aged care-specific treatment guidelines, documentation forms, and audit and feedback strategies that will target aged care staff, general practitioners, pharmacists, and residents and their families. The intervention will primarily focus on urinary tract infections, lower respiratory tract infections, and skin and soft tissue infections. RACFs will transition from control to intervention phases in random order, two at a time, every 2 months, with a 2-month transition, wash-in period. The primary outcome is the cumulative proportion of residents within each facility prescribed an antibiotic during each month and total days of antibiotic use per 1000 occupied bed days. Secondary outcomes include the number of courses of systemic antimicrobial therapy, antimicrobial appropriateness, antimicrobial resistant organisms, Clostridioides difficile infection, change in antimicrobial susceptibility profiles, hospitalisations and all-cause mortality. Analyses will be conducted according to the intention-to-treat principle.Ethics and disseminationEthics approval has been granted by the Alfred Hospital Human Research Ethics Committee (HREC/18/Alfred/591). Research findings will be disseminated through peer-reviewed publications, conferences and summarised reports provided to participating RACFs.Trial registration numberNCT03941509.

An investigation of residential facility staff usage of touchscreen technology

2017 ◽  
Vol 29 (12) ◽  
pp. 2095-2098 ◽  
Author(s):  
Samantha M. Loi ◽  
Alissa Westphal ◽  
Nicola T. Lautenschlager
Keyword(s):  
Older Adults ◽  
Technology Acceptance ◽  
Aged Care ◽  
Ease Of Use ◽  
Residential Aged Care ◽  
Training Methods ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Acceptance Model

ABSTRACTOlder adults may become more familiar and interested in using touchscreen technology (TT). TT can be used to engage older adults living in residential aged care facilities (RACFs) and staff there can play an important role in supporting residents to use TT. However, before these are introduced, it is crucial to investigate their opinions in using TT with residents. A questionnaire based on the Technology Acceptance Model was administered to assess staff usage and confidence in using TT, their perceptions in TT ease-of-use and usefulness in helping them care for their residents. Perhaps unsurprisingly, results found that respondents were familiar using TT. More importantly, staff reported that they were interested in engaging residents with TT and nominated different training methods to support them such as group in-services. This project provides information about staff experience and acceptance of the use of TT for residents in RACFs.

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