Implementation of a Multicomponent Intervention to Prevent Physical Restraints in Nursing Home Residents (IMPRINT)

Not Applicable

Completed

• Conditions: Dementia
• Interventions: Other: Educational programme for all nurses; Other: Printed study material; Other: Training and structured support for nominated key nurses; Other: Facultative train-the-trainer module for key nurses; Other: Supportive material (poster, mugs etc.)

• Registration Number: NCT02341898
• Lead Sponsor: University of Luebeck

Brief Summary

Background: Physical restraints as bedrails and belts are still regularly applied in German nursing homes despite clear evidence showing their lack of effectiveness and safety. In a cluster-randomized controlled trial, the efficacy of a guideline-based multicomponent intervention has been shown with a significant reduction in physical restraints use without adverse events. The present study aims to apply different versions of the original intervention in nursing home residents in four different regions throughout Germany in order to evaluate the effectiveness of the programme.

Methods/Design: Pragmatic cluster-randomized controlled trial comparing two intervention groups ((1) updated original programme and (2) brief version of the updated programme) with a control group (3) receiving printed study materials (optimized usual care). Intervention (1) consists of an information programme for all nurses, additional training and structured support for nominated key nurses, and provision of printed study material and other supportive material. For intervention (2) nurses' training is only optional carried out facultatively by key nurses who have received an additional train-the-trainer module. The control group (3) receives printed study material only. Overall, 120 nursing homes including approximately 10800 residents will be recruited, randomized to one of the three groups and followed up for 12 months. The primary outcome is defined as proportion of residents with at least one physical restraint at 12 months. Physical restraint use will be assessed by direct observation. Secondary outcomes are residents' quality of life as well as safety parameters as i.g. falls and fall-related fractures. Process and cost measures will also be assessed.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2014-12-16
• Study First Submitted QC: 2015-01-16
• Study First Posted: 2015-01-19
• Study Start: 2015-03
• Primary Completion: 2017-03
• Study Completion: 2017-03
• Status Verified: 2017-05
• Last Update Submitted: 2017-05-02
• Last Update Posted: 2017-05-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 10800

Inclusion Criteria

• randomly selected nursing homes in each region; no specific inclusion criteria will be applied

Exclusion Criteria

• no specific exclusion criteria will be applied

Individual level

Inclusion Criteria:

• all residents within the cluster present on the day of data collection
• all residents newly admitted to clusters during follow-up and present on the day of follow-up data collection

Exclusion Criteria:

• no specific exclusion criteria will be applied

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Updated original programme	Supportive material (poster, mugs etc.)	Educational programme for all nurses (90 min. single information session); training and structured support for nominated key nurses (one-day training workshop); provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives); supportive material (poster, mugs etc.)
Updated original programme	Educational programme for all nurses	Educational programme for all nurses (90 min. single information session); training and structured support for nominated key nurses (one-day training workshop); provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives); supportive material (poster, mugs etc.)
Concise updated programme	Supportive material (poster, mugs etc.)	Training and structured support for nominated key nurses (one-day training workshop); nurses' training will be carried out by key nurses as facultative option; key nurses receive an additional train-the-trainer module to apply the educational programme; provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives); supportive material (poster, mugs etc.)
Optimized usual care	Printed study material	Provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives) only
Updated original programme	Training and structured support for nominated key nurses	Educational programme for all nurses (90 min. single information session); training and structured support for nominated key nurses (one-day training workshop); provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives); supportive material (poster, mugs etc.)
Updated original programme	Printed study material	Educational programme for all nurses (90 min. single information session); training and structured support for nominated key nurses (one-day training workshop); provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives); supportive material (poster, mugs etc.)
Concise updated programme	Training and structured support for nominated key nurses	Training and structured support for nominated key nurses (one-day training workshop); nurses' training will be carried out by key nurses as facultative option; key nurses receive an additional train-the-trainer module to apply the educational programme; provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives); supportive material (poster, mugs etc.)
Concise updated programme	Facultative train-the-trainer module for key nurses	Training and structured support for nominated key nurses (one-day training workshop); nurses' training will be carried out by key nurses as facultative option; key nurses receive an additional train-the-trainer module to apply the educational programme; provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives); supportive material (poster, mugs etc.)
Concise updated programme	Printed study material	Training and structured support for nominated key nurses (one-day training workshop); nurses' training will be carried out by key nurses as facultative option; key nurses receive an additional train-the-trainer module to apply the educational programme; provision of printed study material (evidence-based practice guideline; short versions for nurses, legal guardians, and others; information brochures for relatives); supportive material (poster, mugs etc.)

Primary Outcome Measures

Name	Time	Method
Proportion of residents with at least one physical restraint assessed through direct observation by blinded research assistants	12 Months

Secondary Outcome Measures

Name	Time	Method
Residents' quality of life (measured by QoL-AD)	12 Months	Will be measured by QoL-AD for a randomly selected subgroup of 10% of residents
Falls and fall-related fractures	12 Months
Costs within trial period (cost parameters related to the implementation of the intervention as well as outcome-related cost parameters)	12 Months	For economic evaluation cost parameters related to the implementation of the intervention will be collected as well as outcome-related costparameters; explicit trial-associated will not be taken into account

Trial Locations

Locations (4)

Witten/Herdecke University; 🇩🇪 Witten, Nordrhein-Westfalen, Germany

Martin-Luther-University Halle-Wittenberg; 🇩🇪 Halle (Saale), Sachsen-Anhalt, Germany

University of Hamburg; 🇩🇪 Hamburg, Germany

University of Lübeck; 🇩🇪 Lübeck, Schleswig-Holstein, Germany