Training and Coaching to Promote High Performance in Veteran Affairs (VA) Nursing Home Care

Study Overview
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Brief Summary
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This study aimed to explore the feasibility of an educational intervention to strengthen workplace learning systems in four VA Community Living Centers (CLCs).

Detailed Description
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Background: The study explored the feasibility of an educational intervention to strengthen workplace-learning systems in four VA Community Living Centers (CLCs). Objectives: Specific aims were to 1) conduct a feasibility study to assess whether the educational intervention is practical to implement as designed and 2) conduct a pilot study to validate the methodology proposed for assessing outcomes of this educational intervention. Methods: A multi-level intervention targeting the translation of workplace learning into practice was implemented. The Direct Care Worker (DCW) intervention targeted both clinical knowledge and effective communication. The Coaching Supervision training addressed management and supervision practices for nurses, combined with effective communication. Four CLCs received both interventions, administered by the Paraprofessional Health Institute (PHI), using a train-the-trainer approach over the course of four 3-day sessions. Quantitative and qualitative data were collected to assess factors influencing effectiveness of implementation and to understand the impact of the trainings on participants. Status: The study has been completed with educational interventions implemented and qualitative and quantitative data collected.

Official Title
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Training and Coaching to Promote High Performance in VA Nursing Home Care

Conditions
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Dementia

Intervention / Treatment
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* Behavioral: Educational Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: VA Employees: psychologists, nurse-managers and front-line nursing care staff assigned to CLCs will be included Exclusion Criteria: Those not working in the CLC, Those working in the CLC but not involved in the training intervention that is the focus of the study (e.g. Environment Management Service personnel, dietary personnel)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Training Feasibility<br>4 sites will receive the training intervention to determine the feasibility of the train-the trainer approach. The educational intervention is included in this arm. | Behavioral: Educational Intervention<br>* The intervention consists of two (2) different types of training, both to be delivered through a train-the-trainer approach. The first of these is coaching-supervision training for nurse managers and other supervisory personnel in the CLC units. The second component is a one-day training for DCWs on communication and managing problem behaviors associated with dementia. These two trainings build on validated training models that have been developed by PHINational, but will be adapted and customized to include VA-developed clinical content on the management of problem behaviors associated with dementia.<br>|
| Other: Data Collection - Survey<br>Survey data collection tools will be piloted to assess feasibility of survey administration and development of the survey for future studies. This tools were piloted in sites where the educational intervention was administered. | Behavioral: Educational Intervention<br>* The intervention consists of two (2) different types of training, both to be delivered through a train-the-trainer approach. The first of these is coaching-supervision training for nurse managers and other supervisory personnel in the CLC units. The second component is a one-day training for DCWs on communication and managing problem behaviors associated with dementia. These two trainings build on validated training models that have been developed by PHINational, but will be adapted and customized to include VA-developed clinical content on the management of problem behaviors associated with dementia.<br>|
| Other: Data Collection - Interview<br>Interview data collection tools will be piloted to assess feasibility of interview administration and development of the interview protocol for future studies. This tools were piloted in sites where the educational intervention was administered. | Behavioral: Educational Intervention<br>* The intervention consists of two (2) different types of training, both to be delivered through a train-the-trainer approach. The first of these is coaching-supervision training for nurse managers and other supervisory personnel in the CLC units. The second component is a one-day training for DCWs on communication and managing problem behaviors associated with dementia. These two trainings build on validated training models that have been developed by PHINational, but will be adapted and customized to include VA-developed clinical content on the management of problem behaviors associated with dementia.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Completion of Training Intervention | This outcome measures the number of participants that fully completed the training intervention. | This outcome was assessed at the end of the 1 year pilot study. | 
| Facility Implementation of Trainings | This measure assesses the number of participating facilities (4) that implemented trainings in their own facilities upon completion of our educational training intervention. | This outcome was assessed at the end of the 1 year pilot study. | 
| Number of Participants in Pilot Surveys | This outcome measures the number of participants that completed the survey during the pilot in order to assess the feasibility of conducting a larger study. | This outcome was assessed at the end of the 1 year pilot study. | 
| Number of Participants in Pilot Interviews | This outcome measures the number of participants that participated in interviews that were conducted during the pilot in order to assess the feasibility of conducting a larger study. | This outcome was assessed at the end of the 1 year pilot study. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Nursing Homes, Implementation of innovative programs, Nursing staff, Nurses' aides, Educational models