NRC:Improving Healthcare for Cognitively Impaired Elders and Their Caregivers

Study Overview
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Brief Summary
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An multi-stage mixed-method design will be employed to obtain both qualitative and quantitative data to address two study aims: (1) Evaluate and refine the delivery Reducing Disabilities in Alzheimer's Disease (RD- AD) training to advanced practice nurses and (2) Evaluate and refine the implementation of RD-AD by advanced practice nurses in their medical settings.

Detailed Description
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Two waves of APNs (25 each wave/total 50) will receive RDAD training and be queried pre and post- training using both qualitative and quantitative procedures to determine: (1) Is RDAD training successfully received by advanced practice nurses? (2) Do they report it as relevant to improving the care they deliver to persons with Alzheimer's Disease and Related Dementias (ADRD)? (3) Does RDAD training of advanced practice nurses improve their level of knowledge about ADRD, their skills in providing ADRD care, and their level of confidence in providing this care? A subset of advanced practice nurses (5 per wave, total of 10) will be recruited to implement RDAD as part of their ongoing care of persons with ADRD.

Official Title
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NRC: Improving Healthcare for Cognitively Impaired Elders and Their Caregivers

Conditions
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Alzheimer Disease, Nurse Training

Intervention / Treatment
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* Behavioral: RDAD Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Licensed by the Washington state Department of Health as an Advanced Registered Nurse Practitioner (ARNP), Hold a board certification as a Gerontological Nurse Practitioner, Adult Nurse Practitioner, or Family Nurse Practitioner, Work at least half time (0.50 FTE) in a clinical setting (primary care, internal medicine, sub-specialty, medical home), with a panel consisting of over 25% of patients over 65 years of age, Have no expectation for termination over the course of the study; and Agree to participate in all phases of the RDAD translational program. Exclusion Criteria: NA
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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: RDAD training to APNs<br>Half-day workshop to provide APNs with all skills necessary to conduct RDAD in their clinical settings. A subset of the trained APNs will implement RDAD as part of their ongoing care of persons with ADRD. | Behavioral: RDAD Training<br>* An interactive processes of lecture, role-play, and discussion, APNs will have the opportunity to dissect all phases of RDAD to insure they understand the objectives, can enact the program, and feel confident they can problem-solve situations that arise. APNs will receive materials to insure they are knowledgeable about ADRD symptoms, behavior management techniques, and exercise safety.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physician Confidence in Dementia Care Skills | A 12-item self-report measure (administered to ARNPs) designed to measure perception of ability to address the care needs of patients with ADRD. | Change from baseline score at 2 months | 
| Sense of Competence in Dementia | A 17-item questionnaire covering 4 domains: job satisfaction, attitude towards dementia, work experience, and level of dementia knowledge. | Change from baseline score at 2 months | 
| Dementia Attitudes Scale | A 20-item scale to measures attitudes towards dementia with a two-factor structure; dementia knowledge and social comfort. | Change from baseline score at 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Focus Group Questions | Questions to determine satisfaction with a acceptability of RDAD | At 2 months | 
| Implementation Questions | Questions to determine Acceptability of RDAD | At 2 months |