Process evaluation of an implementation study in dementia care (EIT-4-BPSD): stakeholder perspectives.

Area of Science:

• Gerontology
• Healthcare Management
• Implementation Science

Background:

• Behavioral and psychological symptoms of distress in dementia (BPSD) significantly impact resident quality of life and caregiver burden in nursing homes.
• Non-pharmacological interventions are crucial for preventing and managing BPSD.
• The Evidence Integration Triangle (EIT)-4-BPSD is an implementation strategy designed for nursing home staff.

Purpose of the Study:

• To evaluate stakeholder perceptions of the EIT-4-BPSD implementation process.
• To identify barriers and facilitators to implementing the EIT-4-BPSD strategy in real-world nursing home settings.
• To explore the utility of the EIT-4-BPSD strategy.

Main Methods:

• A pragmatic Hybrid III trial was conducted.
• A process evaluation study involved focus groups with stakeholders from nursing homes that completed the 12-month implementation strategy.
• Qualitative data were analyzed using conventional content analysis, organized by the RE-AIM framework.

Main Results:

• 21 nursing homes completed the EIT-4-BPSD strategy, with 93 stakeholders participating in focus groups.
• Over half of the participating nursing homes met their BPSD reduction goals.
• Key implementation factors included family and staff engagement, organizational support, and perceived utility, alongside challenges like regulations and time constraints.

Conclusions:

• Stakeholders provided insights into the feasibility and utility of the EIT-4-BPSD strategy for improving dementia care in nursing homes.
• Engagement of family and staff across all organizational levels is critical for successful implementation.
• Measuring staff, environmental, and resident outcomes is essential for future implementation research.