Silies K^a, Pohontsch N^b, Huckle T^a, Sill J^a, Lühmann D^b, Scherer M^b, Balzer K^a

^aNursing Research Unit, Institute for Social Medicine and Epidemiology, University of Lübeck.

^bDepartment of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf

Background

Older age is associated with increased multimorbidity, leading to complex care needs [1]. Thus, a need for higher qualified nurses has been identified and academic training for nurses has been established in Germany since 2003/2004. Yet, only few academic nurses work in long-term care facilities and potential roles are unclear.

Objective

The purpose of the Expand-Care project is to develop a defined role of Bachelor’s degree nurses for person-centred care in long-term care facilities and to explore potential effects on residents’ and nurses’ level.

Methods

The project comprises a development and a pilot phase. Development was based on systematic literature searches, a multiple case study (DRKS00025773) and two stakeholder workshops. The analyses yielded core competence areas which were translated into intervention components on residents’ level (e.g. case conferences). Implementation strategies were developed based on the CFIR/ERIC framework [2]. Feasibility and potential effects of the intervention will be explored in a pilot cluster-randomised controlled trial in 12 nursing homes with 15 residents and one academic nurse per cluster and a 6-months follow-up. Outcomes on residents’ level will be health service utilisation, quality of life and proximal outcomes (e.g. physical functioning and delivery of care). A mixed methods process evaluation will be embedded.

Results

The new role of Bachelor’s degree nurses focuses on management of chronic diseases and empowerment of residents. Main implementation strategy will be a training of 300 hours blended learning for intervention group nurses. At the conference, the intervention programme will be presented in detail.

Conclusions

Expand-care is the first study in Germany to explore the implementation of a defined role for academic nurses with expanded competencies in nursing homes. Results will help to improve employment of academic nurses in long-term care and enhance person-centred high-quality care for residents.

References

1. Kiljunen O, Välimäki T, Kankkunen P, Partanen P. Competence for older people nursing in care and nursing homes: An integrative review. Int J Older People Nurs. 2017 Sep;12(3). doi: 10.1111/opn.12146. Epub 2016 Dec 29.
2. Regauer V, Seckler E, Campbell C, Phillips A, Rotter T, Bauer P, Müller M. German translation and pre-testing of Consolidated Framework for Implementation Research (CFIR) and Expert Recommendations for Implementing Change (ERIC). Implement Sci Commun. 2021 Oct 19;2(1):120. doi: 10.1186/s43058-021-00222-w.

Silies K, Pohontsch N, Huckle T, Sill J, Lühmann D, Scherer M, Balzer K (2022, 7.-8. Juli). Expand-Care: Intervention Development and Pilot Study [Vortrag]. Summer Conference 2022, Vilnius, Litauen.