Project summary:

Objective: To assess the effect of the Blended Gaming COVID-19 Training System (BGCTS) on infection control practices, compliance rates and knowledge of standard precautions among all staff in residential care homes (RCHs). Design: A 2-arm single-blinded cluster randomized controlled trial. Setting: Twenty RCHs (out of the 70 RCHs in the established network). Participants: 188 staff (from 20 RCHs) will be randomized to the intervention group (IG) or the control group (CG) according to their RCHs. Intervention: The intervention is a blended mode of training (e-health mode blended with face-to-face sessions) and the contents are derived from ‘The COVID-19 Risk Communication Package For Healthcare Facilities developed by the World Health Organization. E-health mode refers to a 120-minute web-based training system covering 8 topics in 2 weeks. Short-clip videos and games are used. Two face-to-face 30-minute interactive sessions will be arranged for clarifying concepts. Main outcome measures: Primary outcome: compliance rate of hand hygiene and infection control practices (by non-participatory observations with a checklist on infection control practices). Observation will be made of the staff in the IG and CG when they are working in the facilities. Secondary outcomes: Knowledge and attitudes towards infection control (KAIC) and Self-reported Infection Control Practice (SICP) Expected outcomes: BGCTS will improve staff’s performance at infection control practices. The BGCTS is the first of this kind training, addressing the diverse health literacy levels of staff and helping RCH staff to comply with WHO infection control guidelines. RCHs can adopt BGCTS in staff development training in the future.

Project summary:

BrainLive, funded the Simon K.Y. Lee Foundation, is a 2-year project that mainly aims to develop a best practice model of barrier-free online dementia community support service using information and communications technology (ICT) and productive ageing to deliver intervention and care. In 2 years, we will develop a tested model that is effective and equitable, with good economic value for society, and ready to be widely implemented in various community service settings. The project targets to test the feasibility, acceptability and sustainability of an online community-based dementia service model consisting of a package of evidence-based social care and intervention services for families living with dementia delivered via ICT tools with trained young-old volunteers support, with the following objectives: 1) ensure access to evidence-based intervention and care under infection control situations; 2) prepare families living with dementia and service providers for future remote service development by enhancing their ICT literacy in the post-pandemic era; 3) build capacity of the community to care for families living with dementia by developing young-old volunteers for remote dementia service; 4) promote innovations by NGOs to explore full potentials of ICT-enriched service for continued service, including involvement of carers in the long-term; and 5) identify using service data the best combination of the standard service package and other infrastructure and support for an optimised model to recommend in Hong Kong.

Project summary:

Background

Scottish care homes are vulnerable to the widespread transmission of COVID-19 and poor outcomes. The COVID-19 pandemic has disproportionately high fatality rates among older adults, particularly those with comorbidities.

Care homes provide health and care services for approximately 40,000 residents, of which the majority are elders with complex medical and care needs.

COVID-19 has had a significant impact on the care homes within Lanarkshire, similar to other local authorities. While there is a plethora of research focusing on the spread of COVID-19 in the general population, research on the unique transmission dynamics and interventions for COVID-19 in care homes is negligible.

Infection control interventions in care homes need to be both effective in containing the spread of COVID-19 and also feasible to implement in this setting which has a dual nature: a healthcare institution and a home.

Research Aims

This research aim to:

• evaluate the effectiveness of a range of interventions strategies in controlling COVID-19 in care homes
• investigate the impact of staff sharing between care homes in Lanarkshire on the inter-facility transmission of COVID-19
• answer emerging questions for care home stakeholders from Lanarkshire

Project summary:

The need for rehabilitation for COVID-19 patients is escalating. The team will develop and evaluate a training package for NHS/social care staff to support them during remote assessment and management of COVID-19 patients requiring rehabilitation. This is challenging to do remotely, as balance and mobility cannot be easily assessed. The staff will be provided with practical guidance and training to increase their skills.

Project summary:

The COGER study is collecting data to gain insight into the course of functional and medical recovery in older people affected by COVID-19 participating in rehabilitation across Europe.
The COGER study, designed by members of the Special Interest Group for Geriatric Rehabilitation of the European Geriatric Medical Society (EuGMS), study aims to:
1. Explore the course of activities of daily living (ADL) recovery and influencing factors
2. Describe other outcomes after geriatric rehabilitation in post-COVID-19 patients
3. Describe geriatric rehabilitation services provided to post COVID-19 patients across Europe.

The study has recruited over 700 patients between September 1, 2020 and November 1, 2021.

Project summary:

Developing countries already contain large numbers of older people with social care needs, leading to a rapid growth in private provision, including residential services. Many operate on an informal, entirely unregulated basis. We have developed an online platform for sharing information about the quality of services in care homes for the city of La Plata, Argentina. This responded to concerns about poor service quality, an absence of public information and the limited capacity of official local regulators. The site, launched in 2019, consists of a simple interactive information-sharing platform. The site provides updated information about care homes and a set of service quality principles, developed in partnership with care home directors. It enables service users to provide feedback about providers. This feedback is not directly published on the site: instead, complaints are investigated and providers removed from the site if they are confirmed. The site also provides general information for service users to support the selection and assessment of social care services, and (more recently) the status of the COVID-19 pandemic in local care homes. Our project will evaluate the La Plata intervention, along with new related projects by other organisations in Argentina. We will assess the feasibility and potential benefits of scaling up over the next three years.

Project summary:

The WHELD well-being training intervention for care homes has shown benefits in two clinical trials by improving quality of life, mental health and reduced use of sedatives, and has been developed for virtual supervision. It has now been adapted to the COVID-19 context and evaluated in a RTC; an “implementation ready” programme will then be rolled out for care homes nation-wide.

Project summary:

The Dementia Isolation Toolkit was developed to provide evidence-informed guidance to support infection prevention and control measures that are consistent with person-centered care within long term care homes (LTCHs) during the pandemic. This project is a four-phase mixed-methods, research study evaluating the impact of the DIT intervention on outcomes related to 1) achieving safe, effective, and compassionate isolation of residents and 2) levels of moral distress amongst LTCH staff in three LTCHs situated in rural and city settings. The effectiveness of the DIT and the processes developed for its implementation will also be explored through developmental evaluation. Our approach includes multiple rapid quantitative (e.g., administrative/clinical surveys) and qualitative (e.g., interviews) analyses with up to 130 LTCH staff and family caregiver participants. We will directly engage these same knowledge users in the implementation process as part of the developmental evaluation, to increase the potential impact of the DIT intervention.

Project summary:

Palliative care is commonly misunderstood as only being relevant for people who are actively dying and in the final weeks or days of life. However, the relief of suffering through the provision of holistic and compassionate care is an essential component of care for all patients with a life-threatening illness. Among newly-admitted residents to long-term care (LTC) homes, where median life expectancy is just 18 months, most receiving care in this setting have limited life expectancy and can benefit from palliative care.

In this project, we will adopt an implementation science approach to evaluate the use of the Risk Evaluation for Support: Predictions for Elder-life in the Community Tool in LTC (RESPECT–LTC) to support their ongoing efforts to embed palliative approaches to care in their processes and culture. RESPECT–LTC is a mortality-risk communication tool that accurately predicts an older person’s six-month mortality risk as well as life expectancy to inform decision-making regarding the initiation of palliative and end-of-life care.

Project summary:

Knowledge users have identified a need to improve palliative care in long-term care (LTC) homes in Ontario and Alberta, and investigators in these provinces have access to data to conduct rapid implementation research. Our 3 main objectives are: 1. Data measurement to detect variations in end-of-life medication prescribing (proxy to palliative care delivery) before and during COVID-19; 2. Mixed methods evaluation to understand the barriers/facilitators of end-of-life prescribing in LTC; and 3. Intervention to support homes in both provinces, focusing on those most challenged to provide end-of-life care during COVID-19. For the quantitative component, we will use data on LTC homes in Ontario and Alberta held at Institute for Clinical and Evaluative Sciences (ICES) and Alberta Health Services (AHS). For the qualitative component, we will reach out to LTC homes identified as being top/bottom prescribers and interview staff, healthcare providers, and resident caregivers at these homes to gain a deeper understanding of the quantitative findings.

Project summary:

This study is a partnership between MedSafer, Point Click Care (PCC) and two Ontario long term care homes (Hillel Lodge in Ottawa and Kensington Gardens in Toronto). Providing comprehensive medication management is critical during the pandemic to optimize the care received by older adults, who are at high risk of COVID-19 complications. We previously integrated MedSafer, a software for deprescribing, into the PCC electronic medical record. We will be piloting the integration of the software into the workflow of two long term care homes during the ongoing COVID-19 pandemic. We aim to test the feasibility and user experience of providing electronic decision support for medication management, in order to improve care during and beyond COVID-19. This process is expected to decrease harmful or unnecessary medications, improve staff safety and efficiency and lead to better outcomes for residents.

Project summary:

This study is a two–phase adaptation and implementation project of evidence-based health workforce interventions developed by our team to support health and wellbeing of staff and residents in two Long-Term Care Homes (LTCHs) in Ontario during the COVID-19 pandemic. The implementation of workforce interventions will be led by Nurse Practitioners (NPs). NPs are ideally placed to successfully implement and sustain the recommendations due to their dual clinical and leadership roles, as revealed by the findings of our previous qualitative study involving 14 NPs throughout Ontario. In phase 1 the interventions will be selected and adapted to the context; staff needs and staff characteristics within the 2 LTCHs. Phase 2 involves an effectiveness-implementation hybrid design which will assess adaptation and preliminary efficacy of the implementation of recommendations selected in Phase 1. The expected outcome is a reduction in staff moral distress following the implementation of the intervention.

Project summary:

The “Presence of Family: (Re)Integrating Essential Care Partners in Ontario’s LTC Homes” project will help to develop and disseminate an intervention to allow family members (who are chosen by the resident and who provide them with physical/psycho-social care) to have safe access to the LTC home. We will work with three Ontario LTC homes to implement an intervention that combines training with a commitment to follow safety protocols and use ID badges, and facilitates greater access for essential care partners to the home. We will use developmental evaluation, a rapid scoping review, an economic analysis of the value of the care provided by family members, and a mixed methods outcome evaluation. To spread the learning from this work, we will convene an Advisory Board that includes members from participating LTC homes, family members, and other stakeholders.

Project summary:

The goal of our project is to evaluate the implementation process, the viability and the acceptability of interventions aimed at favouring the presence of relatives (in person or virtually) in 5 LTC’s in Quebec City and in a rural area. We chose patients with Alzheimer’s disease and other dementias as population. We want to assess the characteristics of the LTC’s, facilitating factors and barriers to the implementation of interventions, and the acceptability of the interventions to care staff, family members and the elderly patients. In addition, we will look at the results in the elderly and their relatives. Finally, a cost effectiveness study will be carried out. An evaluative research design is preferred in order to assess the conditions of implementation and document the preliminary effects of the interventions. A multiple case study will be carried out.

Project summary:

IMPACT-COVID-19 (IMPACT-C) has established an infrastructure to develop and evaluate SARS-CoV-2 vaccination strategies among diverse skilled nursing facility (SNF) residents and staff. These efforts have included leveraging the NIA IMPACT Collaboratory’s Data Sharing Collaborative that includes 12 national companies with >1,000 SNFs. We have used this data to evaluate disparities in SARS-CoV-2 testing practices for SNF staff, to inform future policies on the impact of shift and race on testing practices (manuscript in progress). We have additionally completed a cluster RCT of 137 SNFs to compare the effect of a multi-component COVID-19 vaccine campaign versus usual care on the number of staff that complete COVID-19 vaccinations during the federal Pharmacy Partnership Program in the US (manuscript in press). Thus, IMPACT-C is well-poised to inform future vaccination strategies across SNFs aimed at equitable uptake for residents and staff.