Audit and Feedback Interventions With Primary Care Nursing Teams

NCT04043468 | Withdrawn

• 1 other identifier: CharlesLeMoyne
• Study Type: interventional
• Target: N/A
• Locations: 0 countries
• Sites: N/A

Brief Summary

Audit and feedback (A\&F) aims to improve practices by providing professionals with a summary of their performance. A major limitation to its effectiveness is a persistent intention-action gap following the feedback that prevents the translation of planned actions into concrete changes in practice. In nursing, the lack of coordination within nursing teams contributes to this gap and therefore limits their capacity for action. The objective of this study is to evaluate the effects of an A\&F intervention enhanced with an action support component on the primary care nursing teams' capacity to improve performance compared to a standard A\&F intervention. A pragmatic cluster randomised controlled trial with analysis of implementation fidelity will be conducted. Four nursing organizations will receive standard A\&F, while the other four will receive A\&F with a support component. We will measure performance using clinical administrative data from an electronic database based on wound care episodes. Performance indicators will be measured 3 times: at the beginning of the study (T1), after 6 months (T2) and after 12 months (T3). The feedback meetings will take place between times 1 and 2, then between times 2 and 3. The intervention group will receive the support component in the form of structured focus groups in addition to the feedback meetings. Changes in rates of seven nursing-sensitive indicators (continuity, planning and adjusting of the treatment plan, initial assessment, education, frequency and number of consultations and duration of episodes) will be measured to evaluate the effects of A\&F on performance. The results are expected to inform of the effectiveness of A\&F in order to improve its design and deployment. The potential impact on the improvement of practices is significant, considering that wound care is one of the main conditions in primary care for which nursing staff have a high degree of autonomy.

Conditions

Nurse's Role

Keywords

audit and feedback; process indicators; quality

Outcome Measures

Primary Outcomes (7)

• Continuity

  Percentage of care episodes in which at least 50 % of the consultations are provided by the same professional

  Change from baseline continuity at 6 and 12 months.

• Planning and adjusting of the treatment plan

  Percentage of care episodes in which at least 75 % of the consultations are with an RN

  Change from baseline Planning and adjusting of the treatment plan at 6 and 12 months.

• Education

  Percentage of care episodes in which at least one education session is provided

  Change from baseline Education at 6 and 12 months.

• Initial assessment

  Percentage of care episodes in which a RN performs a wound assessment in the first consultation

  Change from baseline Initial assessment at 6 and 12 months.

• Frequency

  Percentage of care episodes with no more than three consultations per week as of the second week

  Change from baseline Frequency at 6 and 12 months.

• Duration

  Percentage of care episodes lasting 42 days or less

  Change from baseline Duration at 6 and 12 months.

• Intensity

  Percentage of care episodes with no more than 22 consultations

  Change from baseline Intensity at 6 and 12 months.

Study Arms (2)

Improved A&F intervention

EXPERIMENTAL

Two feedback sessions and four structured focus groups

Other: Audit and feedback

Standard A&F intervention

ACTIVE COMPARATOR

Two feedback sessions

Other: Audit and feedback

Interventions

Audit and feedback OTHER

Audit and feedback (A\&F) is an intervention that aims to improve professionals practices by providing professionals with a summary of their performance over a period of time.

Improved A&F intervention; Standard A&F intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may not qualify if:

• Wound care episodes in palliative care will be excluded, as the indicators were selected for episodes of wound care with healing potential. Such episodes are identifiable by codes in the database.

Sponsors & Collaborators

• CR-CSSS Champlain-Charles-Le Moyne: lead

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 20, 2019
• First Posted: August 2, 2019
• Study Start: September 2, 2021
• Primary Completion: September 2, 2023
• Study Completion: September 2, 2024
• Last Updated: January 27, 2021

Record last verified: 2021-01

Data Sharing

• IPD Sharing: Will not share