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Implementing the theory-based advance care planning ACP+ programme for nursing homes: study protocol for a cluster
Joni Gilissen1,2,3, Lara Pivodic4, Annelien Wendrich-van Dael4
1End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium. joni.gilissen@vub.be.
BMC Palliative Care
|January 10, 2020
Summary
This study evaluated the ACP+ program to improve advance care planning (ACP) in nursing homes. The ACP+ program showed potential for enhancing staff knowledge and self-efficacy in implementing ACP.
Area of Science:
- Gerontology
- Healthcare Management
- Clinical Trials
Background:
- Improving advance care planning (ACP) in nursing homes is crucial.
- The ACP+ program is a theory-based, multicomponent intervention designed to integrate ACP into routine nursing home care.
- A cluster randomized controlled trial (RCT) protocol is described to evaluate ACP+ effectiveness.
Purpose of the Study:
- To evaluate the effects of the ACP+ program on nursing home staff and volunteers.
- To assess the underlying processes of change associated with ACP implementation.
- To provide evidence for improving ACP uptake among nursing home residents and their families.
Main Methods:
- A cluster RCT involving 14 nursing homes in Flanders, Belgium.
- Pair-matched randomization to either the ACP+ program (8-month intervention) or usual care.
- Primary outcomes: staff knowledge and self-efficacy in ACP. Secondary outcomes: staff attitudes, ACP practices, and self-efficacy of support staff and volunteers.
- Mixed-methods process evaluation alongside outcome evaluation.
Main Results:
- The study is ongoing, with data collection and analysis planned.
- The primary outcomes focus on measurable improvements in staff's understanding and confidence regarding ACP.
- Secondary outcomes aim to capture broader impacts on attitudes and practices within the nursing home setting.
Conclusions:
- High-quality evidence on ACP effectiveness in nursing homes is limited.
- This study aims to contribute robust evidence on the effectiveness and implementation processes of the ACP+ program.
- Findings will inform strategies to enhance ACP for residents and their families in long-term care settings.
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