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Modeling and evaluating evidence‐based continuing education program in nursing home dementia care (MEDCED)—training of care home staff to reduce use of restraint in care home residents with dementia. A cluster randomized controlled trial
Author(s) -
Testad Ingelin,
Mekki Tone Elin,
Førland Oddvar,
Øye Christine,
Tveit Eva Marie,
Jacobsen Frode,
Kirkevold Øyvind
Publication year - 2016
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4285
Subject(s) - dementia , context (archaeology) , intervention (counseling) , medicine , cluster randomised controlled trial , randomized controlled trial , nursing , long term care , nursing homes , geriatrics , family medicine , psychology , psychiatry , paleontology , disease , surgery , pathology , biology
Objective The aim of this study was to evaluate the effectiveness of a tailored 7‐month training intervention “Trust Before Restraint,” in reducing use of restraint, agitation, and antipsychotic medications in care home residents with dementia. Methods This is a single‐blind cluster randomized controlled trial in 24 care homes within the Western Norway Regional Health Authority 2011–2013. Results From 24 care homes, 274 residents were included in the study, with 118 in the intervention group and 156 in the control group. Use of restraint was significantly reduced in both the intervention group and the control group despite unexpected low baseline, with a tendency to a greater reduction in the control group. There was a significant reduction in Cohen‐Mansfield Agitation Inventory score in both the intervention group and the follow‐up group with a slightly higher reduction in the control group, although this did not reach significance and a small nonsignificant increase in use of antipsychotics (14.1–17.7%) and antidepressants (35.9–38.4%) in both groups. Conclusions This study reports on the statistically significant reduction in use of restraint in care homes, both prior and during the 7‐month intervention periods, in both intervention and control groups. When interpreted within the context of the current climate of educational initiatives to reduce restraint and a greater focus on the importance of person‐centered care, the study also highlights the potential success achieved with national training programs for care staff and should be further evaluated to inform future training initiatives both in Norway and internationally. Copyright © 2015 John Wiley & Sons, Ltd.