Engaging Patients in Mutual Goal-Setting in Hospitalized Patients

Study Overview
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Brief Summary
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Mutual goal setting and action planning in patients with long-term conditions in outpatient settings is associated with favorable effects on measures of physical health, psychological health, subjective health status, self-management self-efficacy levels, activation levels, and perceived empowerment. The purpose of this study is to examine the impact of an educational intervention delivered to the staff nurses of two surgical units on how to engage patients in mutual goal-setting in the acute care setting. Staff nurses from two 32-bed surgical units will be scheduled to attend an hour-long educational intervention. A total of 630 chart audits will be conducted one month prior and one and three months following the intervention per unit, to examine the number of patients with a daily goal recorded in the prior 24 hours and the quality of the recorded goal using the SMART-GEM. The self-efficacy of engaging in mutual goal-setting with patients will be examined by asking nurses to complete the Appraisal Inventory Tool (AIT) prior to and immediately following the intervention. The patient experience of engaging in mutual goal-setting will be examined by having a total of 165 patients complete the Patient Experience of Mutual Goal-Setting Tool (PEMGST) one month prior to the intervention and one and three months following the intervention on each of the two units.

Official Title
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Engaging Patients in Mutual Goal-Setting in Hospitalized Patients

Conditions
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Goals

Intervention / Treatment
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* Other: Mutual Goal-Setting Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria At least 18 years of age or older Must be alert and oriented to person, place, and time Inpatient on one of two included units Exclusion Criteria Less than 24 hour length of stay Non English-speaking

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: No Intervention<br>Patients receiving usual care | |
| Experimental: Intervention<br>Patient's receiving care following nurse education on mutual goal-setting | Other: Mutual Goal-Setting Education<br>* Nurses will receive both written and verbal instruction on mutual goal-setting with patients using SMART methodology<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in percentage of charts reviewed with an individualized goal recorded in the electronic health record | percentage of charts reviewed with individualized goals recorded in their electronic health record | Over the course of one month before delivery of education intervention and one and three months post delivery of intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in quality of goals as measured by the SMART-GEM. | Quality of charted individualized goals using talhe SMART-GEM tool. The SMART-GEM (Bowman, Mogensen, Marsland, & Lannin, 2015) is an objective tool that can be used to score the quality of a SMART goal. The interrater agreement on total scores was very good (ICC=.0895, 95% CI = .743 to .986, p=.001) with excellent internal consistency (alpha = .995). | Over the course of one month before delivery of education intervention and one and three months post delivery of intervention | 
| Change in patient experience with mutual goal-setting using the Patient Experience of Mutual Goal-Setting Tool. | Patient experience with mutual goal setting using the Patient Experience of Mutual Goal-Setting Tool, a 5-item survey created by PI to measure the patient experience of mutual goal-setting (involvement, satisfaction, knowledge, feeling heard, achievement of goals). Questions are on a 6-point Likert scale, with higher scores indicating a more favorable experience. | Over the course of one month before delivery of educational intervention and one and three months post delivery of intervention | 
| Change in nurse self-efficacy participating in mutual goal-setting with patients pre and post-intervention using the Appraisal Inventory Tool. | Nurse self-efficacy participating in mutual goal-setting with patients. The Appraisal Inventory Tool is a 5-item survey created by PI to measure nurse self-efficacy for mutual goal-setting using Bandura's (2006) guidelines. The items use an 11-point Likert scale, and higher scores indicate a higher self-efficacy score | Immediately before starting the educational intervention and immediately following the conclusion of the educational intervention |