Exploring the Safewards Programme to Reduce Restrictive Practices in Residential Aged Care: Protocol for a Pilot and Feasibility Study

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2024-09-30 DOI:10.1111/hex.70037

Suzanne Dawson, Candice Oster, Michael Page, Stacey George

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引用次数: 0

Abstract

Introduction

Restrictive practice use in residential aged care homes internationally is unacceptably high. Although policies and legislation mandate the reduction or elimination of restrictive practices, there remains a gap in knowledge regarding strategies that have been effective in achieving a sustained reduction in restraint use. There is an urgent need to identify effective and feasible interventions that aged care staff can implement in everyday practice to reduce restraint use. Safewards is an evidence-based programme that has demonstrated effectiveness in reducing conflict and restrictive practice use in inpatient psychiatric settings and has the potential to address the issue of restraint use in aged care homes. This study aims to evaluate the feasibility of Safewards in reducing restrictive practices in residential aged care homes.

Methods

This pilot and feasibility study will adopt a mixed methods process and outcomes evaluation. Safewards will be implemented in two Australian residential aged care homes. The Reach, Effectiveness, Adoption, Implementation and Maintenance framework will be used to evaluate implementation outcomes. Additionally, the Consolidated Framework for Implementation Research will be used to guide qualitative data collection (including semi-structured interviews with residents/family members, aged care leaders and staff) and explain the facilitators and barriers to effective implementation.

Conclusion

This study will provide pilot evidence on the feasibility of the Safewards programme in residential aged care homes. Understanding the processes and adaptations for implementing and evaluating Safewards in residential aged care will inform a future trial in aged care to assess its effectiveness. More broadly, the findings will support the implementation of an international aged care policy of reducing restrictive practices in residential aged care.

Patient or Public Contribution

A person with lived experience of caring for someone with dementia is employed as a Safewards facilitator and is a member of the steering committee. Residents and family members will be invited to participate in the project steering committee and provide feedback on their experience of Safewards.

Trial Registration

ACTRN12624000044527.

Abstract Image

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探索 "安全计划 "以减少老年寄宿护理中的限制性做法：试点和可行性研究协议》。

导言：在国际上，养老院中限制性措施的使用率高得令人无法接受。尽管政策和法律规定要减少或消除限制性措施，但在持续减少限制性措施使用的有效策略方面仍存在知识空白。目前迫切需要确定有效可行的干预措施，供养老护理人员在日常工作中实施，以减少限制措施的使用。安全卫士 "是一项以证据为基础的计划，在减少住院精神病患者的冲突和限制性措施的使用方面效果显著，并有可能解决养老院使用束缚措施的问题。本研究旨在评估 "安全卫士 "在减少安老院限制性做法方面的可行性：这项试点和可行性研究将采用过程和结果评估相结合的方法。将在两家澳大利亚养老院实施 "安全警告"。将采用 "到达、效果、采用、实施和维护 "框架来评估实施结果。此外，还将使用实施研究综合框架来指导定性数据的收集（包括对居民/家庭成员、养老院领导和员工进行半结构化访谈），并解释有效实施的促进因素和障碍：本研究将为在安老院实施 "安全卫士 "计划的可行性提供试验性证据。了解在安老院实施和评估 "安全策略 "的过程和调整情况，将为今后在安老院开展评估其有效性的试验提供信息。从更广泛的意义上讲，研究结果将有助于实施国际养老护理政策，减少养老院中的限制性做法：患者或公众的贡献：一名具有照顾痴呆症患者生活经验的人士被聘为安全促进者，同时也是指导委员会的成员。住客和家庭成员将受邀参加项目指导委员会，并就他们对安全护理的体验提供反馈意见：试验注册：ACTRN12624000044527。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.