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Prevention of Weight Loss in Long Term Care Veterans - NCT00841412-37212(Clinical Trial 271210)



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City:  Nashville
State:  
TN
Zip Code: 37212
Conditions: Malnutrition
Purpose: Background: Numerous studies have shown that many LTC residents receive inadequate staff assistance with eating, which places them at risk for under-nutrition, dehydration and weight loss. Moreover, improvements in feeding assistance care have been shown to improve residents' daily food and fluid consumption and weight loss outcomes. However, these improvements have only been achieved through the use of research staff as opposed to indigenous LTC staff due to staffing resource limitations that exist in most LTC facilities. The purpose of this program evaluation project is to train indigenous LTC staff how to improve nutritional care within the constraints of existing staffing resources. Objectives: The PI of this proposal has developed standardized assessment, monitoring and staffing needs projection tools that can be used by LTC providers to improve feeding assistance care delivery and unintentional weight loss outcomes. The primary objective of this project is to train indigenous LTC staff how to (1) identify residents in need of feeding assistance, (2) effectively monitor daily care delivery; and, (3) utilize existing, non-nursing staff for some mealtime tasks to improve care. Methods: A multiple baseline design will be used to evaluate the effectiveness of the program in one federal and one state VA LTC facility. Research staff will collect baseline measures related to organizational characteristics, including staffing, nutritional care processes and resident outcomes including oral food and fluid intake and weight status. All LTC units in each of the two sites will be divided into two groups for program implementation purposes (for a total of 4 groups across the 2 sites) based on the proximity of a unit to other units, resident and staff characteristics. The program will be implemented with staff and residents on the units in the first site/group; while, the second site/group remain in usual care and continue to be monitored monthly for all care process and resident outcome measures. Research staff will train LTC staff in the implementation of program protocols during a 12-week intervention period. Research staff will then monitor LTC staff implementation of the program independent of research staff monthly following intervention to determine the sustainability of the program in the absence of research staff. All staff training and monitoring will be repeated for the units in groups three and four. This 3-year program evaluation study will determine the effectiveness and cost of translating efficacious research protocols into care practice to improve the nutritional status of LTC veterans. Status: "In Progress" or "Final IRB approval pending and recruitment scheduled to begin Jan, 2009"
Study summary: Background: Numerous studies have shown that many long term care (LTC) residents receive inadequate staff assistance with eating, which places them at risk for under-nutrition, dehydration and weight loss. Moreover, improvements in feeding assistance care have been shown to improve residents' daily food and fluid consumption and weight loss outcomes. However, these improvements have only been achieved through the use of research staff as opposed to indigenous LTC staff due to staffing resource limitations that exist in most LTC facilities. The purpose of this program evaluation project is to train indigenous LTC staff how to improve nutritional care within the constraints of existing staffing resources. Objectives: The PI of this proposal has developed standardized assessment, monitoring and staffing needs projection tools that can be used by long-term care (LTC) providers to improve feeding assistance care delivery and unintentional weight loss outcomes. The primary objective of this project is to train indigenous LTC staff how to (1) identify residents in need of feeding assistance, (2) effectively monitor daily care delivery; and, (3) utilize existing, non-nursing staff for some mealtime tasks to improve care. Methods: A multiple baseline design will be used to evaluate the effectiveness of the program in one federal and one state VA long-term care (LTC) facility. Research staff will collect baseline measures related to organizational characteristics, including staffing, nutritional care processes and resident outcomes including oral food and fluid intake and weight status. All LTC units in each of the two sites will be divided into two groups for program implementation purposes (for a total of 4 groups across the 2 sites) based on the proximity of a unit to other units, resident and staff characteristics. The program will be implemented with staff and residents on the units in the first site/group; while, the second site/group remain in usual care and continue to be monitored monthly for all care process and resident outcome measures. Research staff will train LTC staff in the implementation of program protocols during a 12-week intervention period. Research staff will then monitor LTC staff implementation of the program monthly following intervention to determine the sustainability of the program in the absence of research staff. All staff training and monitoring will be repeated for the LTC units in groups three and four. This 3-year program evaluation study will determine the effectiveness and cost of translating efficacious research protocols into care practice to improve the nutritional status of LTC veterans. Status: Intervention.
Criteria: Inclusion Criteria: - Long-stay, - free of feeding tube, - not receiving hospice care, - not on a planned weight loss diet, - able to speak English Exclusion Criteria:
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Data Source: ClinicalTrials.gov
Date Processed: July 12, 2010
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