Evaluation of the Impact of a Paramedical Training Program for Nurses and Nursing Assistants on the Length of Stay and Prevention of Hospital Iatrogenic Complications in Elderly Patients
CORRESPAGE
1 other identifier
observational
2,671
1 country
5
Brief Summary
In France, hospitalised elderly patients (EP) aged \>75 years are expected to represent 1/3 of patients by 2030 (22% in 2015). In acute care wards outside geriatrics, the average length of stay increases with age, i.e. 8.5 days after the age of 90 compared with 5.5 days for younger patients. Dependence related to hospitalisation, partly avoidable, occurs in 30 to 60% of patients aged over 70. Faced with this situation Geriatric Mobile Teams (GMT) were created in 2002 to meet the need for geriatric expertise in hospitals and in the community by making punctual evaluations. Expert and multidisciplinary, the GMTs are a referring team for "advice, information and training for health care teams" for the care of vulnerable EPs. The GMTs are dependent on an exclusively medical demand system. The lack of knowledge of a specific care for EPs by nurses and nursing assistants and the occasional contribution of GMTs prevents a systematic targeted a for EP. Over the past 30 years, an American nursing programme (NICHE) aimed at improving the overall care of EPs in hospitals has shown that the training of geriatric resource nurses in speciality wards brought about a significant change in hospital geriatric culture. The training is based on evidence based practice including the HELP programme targeting confusion. The HELP programme has shown that nurses and nursing assistants play a pivotal role in reducing the incidence of hospital confusion. In the USA, the implementation of NICHE begins with the creation of a team of nursing leaders (geriatric/education/clinical care experts), dedicated to the coordination of the training and the companionship of geriatric resource nurses. Within the framework of the targets of the Ségur de la santé 2020 and Ma Santé 2022, our hypothesis is that an adaptation of NICHE to the French health context could improve specific care for EP in specialist wards, reduce the occurrence of complications and reduce the length of stay. Indeed, the GMT would ensure this coordination role in the training and support of a nurse and nursing assistant duo, based on the model of hygiene correspondents, in order to disseminate good geriatric practices.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for all trials
Started May 2023
Longer than P75 for all trials
5 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
May 1, 2023
CompletedFirst Submitted
Initial submission to the registry
June 22, 2023
CompletedFirst Posted
Study publicly available on registry
July 7, 2023
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 1, 2027
ExpectedStudy Completion
Last participant's last visit for all outcomes
July 1, 2027
July 7, 2023
June 1, 2023
4.2 years
June 22, 2023
July 6, 2023
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Length of stay
Length of stay compared between groups according to whether or not geriatric correspondents are in place. This criterion has the advantage of being easy to measure, robust and a reflection of overall care. It depends on the occurrence of complications that can be prevented by the intervention of paramedical staff.
The length of stay is calculated as the number of days between admission to the inclusion service and discharge documented in the medical record, assessed up to one month.
Study Arms (2)
Post-intervention group (Training course group)
The experimental group will be composed of patients aged 75 and over hospitalised in specialised departments after the establishment of geriatric correspondents trained in the specific care for the elderly.
Pre-intervention group (Control group)
The control group will be composed of patients aged 75 years and over hospitalised in specialised departments before the introduction of geriatric correspondents trained in the specific care for the elderly. Their care will be conducted in accordance with usual practices.
Interventions
Training of nurses and nursing assistants, based on the model of hygiene correspondents, in order to disseminate good geriatric practices
Eligibility Criteria
This study covers patients aged 75 and over hospitalised in participating specialitist wards (excluding geriatrics) (medicine, rheumatology, neurology, pneumology, orthopaedic surgery, digestive surgery, ENT and facial surgery)
You may qualify if:
- Patients aged 75 years and over hospitalised in a participating specialtist wards
- not objecting to the study,
- including those under guardianship or curatorship.
You may not qualify if:
- Patient not affiliated to a social security scheme
- Patient at the end of life
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (5)
Centre Hospitalier de Bourg en Bresse
Bourg-en-Bresse, 01012, France
Croix Rousse Hospital
Lyon, 69004, France
CH Annecy Genevois
Metz-Tessy, 74370, France
service de court séjour gériatrique, Hôpital Lyon Sud
Pierre-Bénite, 69495, France
Hôpital Nord-Ouest
Villefranche-sur-Saône, France
MeSH Terms
Interventions
Intervention Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- observational
- Observational Model
- OTHER
- Time Perspective
- RETROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
June 22, 2023
First Posted
July 7, 2023
Study Start
May 1, 2023
Primary Completion (Estimated)
July 1, 2027
Study Completion (Estimated)
July 1, 2027
Last Updated
July 7, 2023
Record last verified: 2023-06