Nursing Home Prevention of Injury in Dementia (NH PRIDE) (NH PRIDE)

This is an interventional prevention trial for Accidental Falls/Prevention and Control focused on measuring Nursing Homes, Elderly, Dementia Read More

Inclusion Criteria:

Facility inclusion criteria:

1. More than 80 long-stay beds
2. Within 30 miles of Boston, Massachusetts or Durham, North Carolina

Resident inclusion criteria:

1. Age ≥ 60 years
2. NH length of stay ≥ 30 days
3. Estimated 2-year risk of hip fracture ≥ 6% using FRAiL model

Provider inclusion criteria:

The NH-PRIDE intervention will target the "usual" providers including nurses, certified nursing assistants (CNAs), physicians, nurse practitioners (NPs), and physician assistants (PAs) routinely caring for NH patients. Nurses should be providing care at a NH facility for a minimum of 2 shifts most weeks. Physicians, NPs, and PAs should spend, on average a minimum of four hours weekly in nursing home care. We estimate there will be 10 providers for the qualitative interviews on injurious falls prevention, 20 providers (4 from each facility) in the televideo sessions, and 60 providers (15 per facility) to participate in the post-intervention questionnaires.

Additional eligibility criteria for providers include:

1. Worked in the facility for ≥ 90 days
2. Can communicate in English (in order to participate in interviews and questionnaires),
3. Over 21 years of age.

Proxy/resident inclusion criteria:

We will recruit 10 residents/proxies to participate in qualitative interviews on falls prevention. Residents/family must meet the following criteria:

1. Affiliated resident has lived in the facility for ≥ 30 days
2. Can communicate in English
3. Over 21 years of age
4. Able to provide informed consent to participate in the interviews

Exclusion Criteria:

Facility exclusion criteria:

1. Population not primarily English speaking
2. Evidence of institutional instability at time of recruitment

Provider exclusion criteria:

1. Does not provide routine care to NH residents (e.g., visiting hospice provider)
2. Does not speak English
3. Is less than 21 years old

Resident exclusion criteria:

1. Advanced dementia as defined by Cognitive Performance Scale (CPS) = 6
2. Life expectancy < 6 months, as indicated by Minimum Data Set (MDS) assessment
3. Living in nursing home for less than 30 days
4. Proxy has communicated wish to opt-out of study Residents will not be excluded from the study based on any specific diagnosis (e.g., congestive heart failure or schizophrenia); however, the algorithm used to make recommendations for medication management will consider individual co-morbidities.

Proxy/resident exclusion criteria for interviews:

1. Affiliated resident has lived in the facility for < 30 days
2. Cannot communicate in English
3. Less than 21 years of age
4. Unable to provide informed consent to participate