A Pilot Study to Evaluate Educational Programs to Improve Fecal Incontinence Care in Nursing Homes

Study Overview
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Brief Summary
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The investigators are planning to do a cluster randomized trial to test the effect of different educational programs for staff according to nursing home patients FI (fecal incontinence). Since there are very few published trials of treatment of FI in older people, and no rigorously evaluated studies on interventions for FI in nursing homes, or rigorously evaluated continence education program for staff concerning continence care, a pilot study is necessary. The aim for the pilot study is to evaluate feasibility, acceptability and adherence according to the educational intervention, methods used and outcome measures. This is designed to be an external pilot study. External pilot studies are small scale versions of the main study which are not intended to be part of the main study. The pilot intervention period is 3 month.

Official Title
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A Pilot Study to Evaluate Feasibility of Educational Programs With Regard to Good Fecal Incontinence Care in Nursing Homes

Conditions
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Fecal Incontinence, Staffs' Attitudes

Intervention / Treatment
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* Behavioral: Educational and counselling program
* Behavioral: Educational program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Nursing homes Wards with 24 hour long term care residency, similar nurse/patient ratio and General Practitioner consultancy, comparable patient groups according to frailty, comparable ward size according to number of patients and staff. Patients All patients on long term residency (1 month or more) are eligible for measurements. Registered nurses (RN) and authorized social educators (ASE) RN's and ASE's with position above 50% are eligible according to participation in the educational meeting and to be recruited as a local opinion leader in intervention 2. All staff is invited to the educational outreach meetings throughout the intervention period. Exclusion Criteria: Nursing homes with diverse staff and patient composition Patients on short term residency Registered nurses (RN) and authorized social educators (ASE) RN's and ASE's with position less than 50%
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: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Educational and counselling program<br>In addition to educational meeting and printed educational material the investigators will include the use of local opinion leaders and educational outreach | Behavioral: Educational and counselling program<br>* Educational and counselling program: In addition to educational meeting and printed educational material the investigators will include the use of local opinion leaders and educational outreach . Local opinion leaders are defined as use of providers nominated by their colleges as educationally influential. Opinion leadership is the degree to which an individual is able to influence other individual's attitudes or overt behavior informally in a desired way with relative frequency. Educational outreach is defined as use of a trained person who meets with providers in their practice setting to give information with the intent of changing the providers practice.<br>|
| Active Comparator: Educational program<br>The investigators want to organize the educational meetings as an interactive workshop that target knowledge, attitudes, and skills at the individual healthcare professional/peer group level. | Behavioral: Educational program<br>* Educational program: Educational meeting and printed educational material Educational meeting is defined as participation of healthcare providers in conference, lectures, workshops or traineeships. The investigators want to organize the educational meetings as an interactive workshop that target knowledge, attitudes, and skills at the individual healthcare professional/peer group level. Printed educational material is defined as distribution of published or printed recommendations for clinical care, including clinical practice guidelines. In general, printed educational material target knowledge and potential skill gaps of individual healthcare professionals.<br>|
| No Intervention: Control group<br>The control group will not receive any educational program. It represents the present real life in nursing homes. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The proportion patients assessed by the clinical guidelines | 90% of the patients assessed by the clinical guideline | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of completed patient health questionnaires | Response rate more than 80% | 3 months | 
| Acceptable performance of multiple choice test measuring change in staff knowledge. | 80% claim that the test set understandable and relevant | 3 months | 
| The proportion of missing data in each completed questionnaire | Less than 10% | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Fecal incontinence, attitudes, knowledge, quality of care