INTERPROFESSIONAL CARE PROCESSES TO MANAGE RESIDENTS WITH HEART FAILURE IN LONG-TERM CARE

Abstract

BACKGROUND: HF affects 20% of long-term care (LTC) residents, in whom it is associated with significant morbidity, acute care transfers, and mortality. Our previous work identified two key barriers to optimal HF management in LTC: staff knowledge gaps and ineffective interprofessional (IP) communication. This pilot study assessed the acceptability, feasibility, and preliminary impact of an intervention designed to: (1) improve staff HF knowledge; (2) develop efficient IP communication processes to better manage residents with HF; and (3) integrate improved HF knowledge and IP communication processes into regular work routines in LTC. METHODS: The intervention was implemented on single units in each of two LTC homes (n= 29 staff). A mixed methods approach was used to collect qualitative (focus groups, interviews, observations) and quantitative (surveys) process and outcome data. HF knowledge surveys and IP scales were collected at baseline and three months post-intervention. RESULTS: Results were similar between participants at both study sites. Baseline scores on the Dutch HF Knowledge Survey varied from 33%-100%, with a mean of 74%. Post-intervention scores ranged from 80%-100%, with a mean of 90%. At baseline, nurses' and personal support workers self-efficacy ranged from 60%-92%, with a mean of 74%; this increased to a range of 70%-94%, with a mean of 87% post-intervention. Participants optimized and developed new communication processes to promote IP care. Observations and interviews indicated a perceived increase in staff confidence, strong assessment and clinical proficiency skills, and more effective IP collaboration. Staff deemed the intervention as useful and feasible, particularly the tools, education, and bedside sessions. CONCLUSION: This pilot study suggests that a novel intervention to enhance knowledge and IP care processes for managing HF in LTC is acceptable and feasible, and has a favourable preliminary impact on staff knowledge and IP communication. Findings of this study inform an expansion of the pilot study to remaining units in each home and beyond, in order to determine the impact of the intervention on HF care quality indicators and resident outcomes.