Dementia Clinical Trial
Official title:
Implementation of a Multicomponent Intervention to Prevent Physical Restraints in Nursing Home Residents: a Cluster-randomized Controlled Trial
Background: Physical restraints as bedrails and belts are still regularly applied in German
nursing homes despite clear evidence showing their lack of effectiveness and safety. In a
cluster-randomized controlled trial, the efficacy of a guideline-based multicomponent
intervention has been shown with a significant reduction in physical restraints use without
adverse events. The present study aims to apply different versions of the original
intervention in nursing home residents in four different regions throughout Germany in order
to evaluate the effectiveness of the programme.
Methods/Design: Pragmatic cluster-randomized controlled trial comparing two intervention
groups ((1) updated original programme and (2) brief version of the updated programme) with
a control group (3) receiving printed study materials (optimized usual care). Intervention
(1) consists of an information programme for all nurses, additional training and structured
support for nominated key nurses, and provision of printed study material and other
supportive material. For intervention (2) nurses' training is only optional carried out
facultatively by key nurses who have received an additional train-the-trainer module. The
control group (3) receives printed study material only. Overall, 120 nursing homes including
approximately 10800 residents will be recruited, randomized to one of the three groups and
followed up for 12 months. The primary outcome is defined as proportion of residents with at
least one physical restraint at 12 months. Physical restraint use will be assessed by direct
observation. Secondary outcomes are residents` quality of life as well as safety parameters
as i.g. falls and fall-related fractures. Process and cost measures will also be assessed.
n/a
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