Evidence map›Paper›PMID 39487534›Full record

ArticleTrials2024

Nurse-led framework to improve the safety and quality of residential aged care (HIRAID® Aged Care): protocol for a stepped-wedge cluster randomised controlled trial.

Ramon Z Shaban, Kate Curtis, Margaret Fry, Brendan McCormack, Deborah Parker, Mary K Lam, Lee-Fay Low, Yun-Hee Jeon, Donna Waters, Richard I Lindley and 11 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Ramon Z ShabanFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Sydney, Australia. ramon.shaban@sydney.edu.au.ORCID http://orcid.org/0000-0002-5203-0557
Kate CurtisFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Sydney, Australia.ORCID http://orcid.org/0000-0002-3746-0348
Margaret FrySchool of Nursing and Midwifery, University of Technology Sydney, Ultimo, Australia, NSW.ORCID http://orcid.org/0000-0003-1265-7096
Brendan McCormackFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Sydney, Australia.ORCID http://orcid.org/0000-0001-8525-8905
Deborah ParkerSchool of Nursing and Midwifery, University of Technology Sydney, Ultimo, Australia, NSW.ORCID http://orcid.org/0000-0003-2552-8613
Mary K LamSchool of Health and Medical Sciences, Royal Melbourne Institute of Technology, Bundoora, VIC, Australia.ORCID http://orcid.org/0000-0001-9451-8203
Lee-Fay LowFaculty of Medicine and Health, School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia.ORCID http://orcid.org/0000-0001-9283-3525
Yun-Hee JeonFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Sydney, Australia.ORCID http://orcid.org/0000-0003-2031-9134
Donna WatersFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Sydney, Australia.ORCID http://orcid.org/0000-0002-3902-1330
Richard I LindleyWestmead Applied Research Centre, University of Sydney, Westmead, Australia, NSW.ORCID http://orcid.org/0000-0002-0104-5679
Karen WatsonFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Sydney, Australia.ORCID http://orcid.org/0000-0003-4934-582X
Moira DunsmoreFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Sydney, Australia.ORCID http://orcid.org/0000-0001-6394-2781
Julie ConsidineCentre for Quality and Patient Safety Research in the Centre for Health Transformation, Deakin University, Geelong, Australia, VIC.ORCID http://orcid.org/0000-0003-3801-2456
Gaynor SquillaciotiSouthern Cross Care, Epping, Australia, NSW.
Lucy ThompsonUPA of NSW Ltd, Wahroonga, Australia, NSW.
Andrea SmithMinchinbury Manor, Rooty Hill, Sydney, Australia, NSW.
Manowara BegumGallipoli Home, Auburn, Australia, NSW.
Jo-Ann DaltonHardi Aged Care, Seven Hills, Australia, NSW.
Clair RamsdenOpal Healthcare, Sydney, Australia, NSW.
Jasmine GlennanWestern Sydney Primary Health Network, Westmead, Australia, NSW.
Catherine ViengkhamFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Sydney, Australia.ORCID http://orcid.org/0000-0002-7802-4219

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe health issues experienced by older people can often be severe and complex, and an increasing number are using residential aged care services to meet their care needs. High-quality nursing care is fundamental to the health and safety of aged care residents and is contingent on nurses' accurate assessment, informed decision-making, and delivery of timely interventions. However, the role of the aged care nurse is often challenging, impeded by factors such as understaffing, high workloads, and a lack of access to clinical infrastructure and resources. When these challenges mount, residents are put at greater risk of adverse outcomes, such as avoidable clinical deterioration and hospital transfers. This study describes the adaptation and implementation of the emergency nursing framework, HIRAID® (History including Infection risk, Red Flags, Assessment, Interventions, Diagnostics, reassessment, communication and plan)-a tool to assist nurses' assessment, decision-making and care in residential aged care.

methodsThe HIRAID® framework will be adapted for residential aged care using a real-time Delphi and panel of aged care and nursing experts. The co-designed HIRAID® Aged Care framework will be trialled in 23 residential aged care homes in Sydney, Australia, in a modified stepped-wedge cluster randomised controlled trial design. All homes will be randomised into one of four clusters. Outcomes of interest include the rate of clinical deterioration events resulting from nurses' actions, the rate of hospital transfers determined to be inappropriate, performance against the national mandatory aged care quality indicators, resident satisfaction with care, nurse and medical staff satisfaction with communication, and the quality of nursing documentation. These outcomes will be evaluated using a combination of qualitative and quantitative analysis of routinely collected resident data, expert assessments of facility documentation events against validated criteria, and pre- and post-intervention surveys of residents, family carers, nurses, and medical staff. DISCUSSION: This protocol describes a pragmatic trial that aims to translate an evidence-based framework from the emergency care context into residential aged care. The adapted HIRAID® Aged Care framework will be the first of its kind to standardise and guide holistic nursing assessment, decision-making, and documentation in residential aged care in Australia. ETHICS AND DISSEMINATION: This research has been approved by the Western Sydney Local Health District Human Research Ethics Committee: 2023/ETH00523. A waiver of consent has been approved to access resident health data and nursing documentation at each participating site.

trial registrationAustralian and New Zealand Clinical Trial Registry, ACTRN12623000481673. Registered 12 May 2023. PROTOCOL VERSION: Version 1.0 6 February 2024.

Indexed as

Homes for the AgedPatient SafetyRandomized Controlled Trials as TopicAgedDelphi TechniqueEmergency NursingGeriatric NursingHumansNurse's RoleNursing HomesPragmatic Clinical Trials as TopicQuality ImprovementQuality Indicators, Health CareClinical deteriorationHealth services for the agedHealth services researchHomes for the agedHospitalizationNursingNursing careQuality of health careResidential facilities

Identifiers

PMID39487534
PMCPMC11528987

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.