Effect of an Educational Program for Staff in Nursing Homes Concerning Patients Fecal Incontinence (EPSPFI)

Norwegian University of Science and Technology

Status: Completed

Conditions: Fecal Incontinence

Treatments: Behavioral: Multifaceted educational program

Study type: Interventional

Funder types: Other

Identifiers

NCT02183740

HiST05

Details and patient eligibility

About

Fecal incontinence (FI) has an increasing prevalence in the geriatric population which cannot be explained by co-morbidity or anatomical and psychological changes of aging alone. In the nursing home population previous studies suggest a prevalence between 10 and 69%, but is most often reported to be between 40 and 55%. FI leads to a high direct and indirect economic burden to the health-care system, and is an important cause og institutionalization of the elderly patients. In addition, FI is associated with shame, social isolation and reduced quality of life.

The importance of identifying treatable causes of FI in the frail elderly, rather than just managing passively, is strongly emphasized. It is indicated that the level of awareness among health personnel regarding appropriate assessment and treatment options is limited, and that FI is considered a normal part of aging.

This study is based on the assumption that FI among nursing home patients can be prevented, cured or ameliorated by offering nursing home staff knowledge of best practise. The primary objective of the study is to test the hypothesis that a multifaceted educational program for staff on assessment and treatment of FI, is associated with a reduction in patients' frequency of FI.

The design of the study is a two armed cluster randomized trail (C-RCT) with a repeated cross-sectional approach.The results will be analysed according to multilevel and longitudinal modelling, and the study will use mixed effect models with the cluster treated as a random effect.

Enrollment: 300 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

Nursing homes with similar:

• patients characteristcs
• care staff/patients ratio
• general practitioner consultancy

Patients:

• All patients on long term care residency (residency >month)

Registered Nurses/authorized social educators:

• All working half time or more

Exclusion criteria

Nursing homes:

• With some kind of speciality (eks rehabilitation, dementia)

Patients:

• Short term care residency

Registered nurses/authorized social educator:

• Working less than half time
• Working only night shifts

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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300 participants in 2 patient groups

Multifaceted educational program

Experimental group

Description:

A multifaceted educational program for nursing home staff consisting of: 1. One seven hours educational meeting (interactive workshop) conducted in the nursing home. Theoretical input and case-base discussions considering guidelines for nurse led assessment og interventions of patients fecal incontinence.The content will be made available as educational material. 2. Recruitment of one local opinion leader per nursing home unit. 3. Seven educational outreach meetings (1 hour 30 minutes per meeting) during the three months intervention period.

Treatment:

Behavioral: Multifaceted educational program

Control

No Intervention group

Description:

The control arm will not receive any educational program and will continue with usual care. Data with information about ordinary care will be gathered as part of the data collection procedure in the study.