权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Testing the Efficacy of FFC-AC-EIT in Patients with Alzheimers Disease and Related Dementias

测试 FFC-AC-EIT 对阿尔茨海默病和相关痴呆症患者的疗效

基本信息

批准号：
10353374
负责人：
Marie Boltz
金额：
$ 46.57万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-01-01 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10353374
关键词：
Abnormal coordination Acute Address Admission activity Adverse event Age Age-Years Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Area Bathing Bed rest Beds Behavioral Symptoms Belief Caring Cognitive Cost Savings Cues Deep Vein Thrombosis Deimplementation Delirium Dementia Discipline of Nursing Disease Education Elderly Emergency department visit Environment Event Fall prevention Family Family Nursing Fright Goals Health care facility Healthcare Systems Hospital Units Hospitalization Hospitals Individual Institutionalization Knowledge Length of Stay Licensed Practical Nurse Long-Term Care Maryland Medical Mental Depression Mentors Methods Modeling Moods Motivation Movement Nurses Nursing Staff Outcome Pain Patient Care Patient Participation Patient Recruitments Patients Pennsylvania Physical Function Physical activity Physical assessment Pilot Projects Pneumonia Policies Prevention Process Quality of life Randomized Recovery Registered nurse Research Resources Risk Sampling Sterile coverings System Testing Training Urinary tract infection Walking Work acute care adverse event risk adverse outcome associated symptom base care coordination caregiving comorbidity cost disability effective intervention efficacy testing experience fall risk falls fear of falling functional decline hospital readmission implementation framework implementation intervention improved innovation medication administration novel strategies older patient person centered post implementation prevent psychological symptom readmission rates recruit relative cost social social cognitive theory vehicular accident willingness

项目摘要

Older adults with Alzheimer’s Disease and Related Dementias (ADRD) comprise approximately 25% of hospitalized older adults. These individuals are at increased risk for functional decline, delirium, falls, behavioral symptoms associated with dementia (BPSD) and longer lengths of stay. Physical activity during hospitalization (e.g., mobility, bathing, dressing) has a positive impact on older adults including prevention of functional decline, less pain, less delirium, less BPSD, fewer falls, shorter length of stay and decreased unplanned hospital readmissions. Despite known benefits, physical activity is not routinely encouraged and older hospitalized patients spend over 80% of their acute care stay in bed. Challenges to increasing physical activity among older patients with ADRD include environment and policy issues (e.g., lack of access to areas to walk); lack of knowledge among nurses on how to evaluate, prevent and manage delirium and BPSD; inappropriate use of tethers; beliefs among patients, families, and nurses that bed rests helps recovery and prevents falls; and lack of motivation/willingness of patients to get out of bed. To increase physical activity and prevent functional decline while hospitalized we developed Function Focused Care for Acute Care (FFC-AC- EIT) for patients with ADRD. Implementation of FFC-AC-EIT changes how care is provided by having nurses teach, cue, and help patients with ADRD engage in physical activity during all care interactions. FFC-AC-EIT was developed using a social ecological model, social cognitive theory and the Evidence Integration Triangle. It involves a four-step approach that includes: (1) Environment and Policy Assessments; (2) Education; (3) Establishing Patient Goals; and (4) Mentoring and Motivating of Staff, Patients and Families. The purpose of this study is to test the efficacy of FFC-AC-EIT within 12 hospitals in Maryland and Pennsylvania randomized to FFC-AC-EIT or Function Focused Care Education Only (EO) with 50 patients recruited per hospital (total sample 600 patients). Aim 1 will focus on efficacy at the patient level based primarily on physical activity, function, and participation in function focused care, and secondarily on delirium, BPSD, pain, falls, use of tethers, and length of stay; and all of these outcomes (except length of stay and tethers) along with emergency room visits, re-hospitalizations and new long term care admissions at 1, 6 and 12 months post discharge; and at the unit level the aim is to evaluate the impact of FFC-AC-EIT on policies and environments that facilitate function and physical activity at 6, 12 and 18 months post implementation. Hospitals randomized to FFC-AC- EIT will be compared with those randomized to Function Focused Care Education Only (EO). Aim 2 will evaluate the feasibility, based on treatment fidelity (delivery, receipt, enactment)136, and relative cost and cost savings of FFC-AC-EIT versus EO. Findings will address several prioritized areas of research: a focus on ADRD; improving physical function; and training of hospital staff and will demonstrate efficacy of an approach to care for patients with ADRD that can be disseminated and implemented across all acute care facilities.

患有阿尔茨海默病和相关痴呆（ADRD）的老年人约占老年痴呆症患者总数的25%