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Compassionate care intervention for hospital nursing teams caring for older people: a pilot cluster randomised controlled trial

Compassionate care intervention for hospital nursing teams caring for older people: a pilot cluster randomised controlled trial
Compassionate care intervention for hospital nursing teams caring for older people: a pilot cluster randomised controlled trial
OBJECTIVE: Compassionate care continues to be a focus for national and international attention, but the existing evidence base lacks the experimental methodology necessary to guide the selection of effective interventions for practice. This study aimed to evaluate the Creating Learning Environments for Compassionate Care (CLECC) intervention in improving compassionate care.

SETTING: Ward nursing teams (clusters) in two English NHS hospitals randomised to intervention (n=4) or control (n=2). Intervention wards comprised two medicines for older people (MOP) wards and two medical/surgical wards. Control wards were both MOP’s.

PARTICIPANTS: Data collected from 627 patients and 178 staff. Exclusion criteria: Reverse barrier nursed, critically ill, palliative or non-English speaking. All other patients and all nursing staff and HCAs were invited to participant, agency and bank staff were excluded.
INTERVENTION: CLECC, a workplace intervention focused on developing sustainable leadership and work-team practices to support the delivery of compassionate care. Control: no educational activity.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary- Quality of Interaction Schedule (QuIS) for observed staff-patient interactions. Secondary- patient-reported evaluations of emotional care in hospital (PEECH); nurse-reported empathy (Jefferson Scale of Empathy).

RESULTS: Trial proceeded as per protocol, randomisation was acceptable. Some but not all blinding strategies were successful. QuIS observations achieved 93% recruitment rate with 25% of patient sample cognitively impaired. At follow-up there were more total positive (78% versus 74%) and less total negative (8% versus 11%) QuIS ratings for intervention wards versus control wards. Sixty-three percent of intervention ward patients scored lowest (i.e. more negative) scores on PEECH connection subscale, versus 79% of control. This was not a statistically significant difference. No statistically significant differences in nursing empathy were observed.

CONCLUSIONS: Use of experimental methods is feasible. The use of structured observation of staff-patient interaction quality is a promising outcome measure inclusive of hard to reach groups.
2044-6055
Gould, Lisa J.
363cc1b3-078d-48eb-a164-feee7dcd9246
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Barker, Hannah
94312934-2508-4d08-a5fe-6f54544f96cf
Libberton, Paula
d6c21e87-26b1-4842-bb74-d897de7dba14
Mesa-Eguiagaray, Ines
581065b0-e101-454a-9954-366ce8b9a00e
Pickering, Ruth
4a828314-7ddf-4f96-abed-3407017d4c90
Shipway, Lisa, Jane
2f67d7f0-be96-4312-a6a9-91b8353240d9
Bridges, Jackie
57e80ebe-ee5f-4219-9bbc-43215e8363cd
Gould, Lisa J.
363cc1b3-078d-48eb-a164-feee7dcd9246
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Barker, Hannah
94312934-2508-4d08-a5fe-6f54544f96cf
Libberton, Paula
d6c21e87-26b1-4842-bb74-d897de7dba14
Mesa-Eguiagaray, Ines
581065b0-e101-454a-9954-366ce8b9a00e
Pickering, Ruth
4a828314-7ddf-4f96-abed-3407017d4c90
Shipway, Lisa, Jane
2f67d7f0-be96-4312-a6a9-91b8353240d9
Bridges, Jackie
57e80ebe-ee5f-4219-9bbc-43215e8363cd

Gould, Lisa J., Griffiths, Peter, Barker, Hannah, Libberton, Paula, Mesa-Eguiagaray, Ines, Pickering, Ruth, Shipway, Lisa, Jane and Bridges, Jackie (2018) Compassionate care intervention for hospital nursing teams caring for older people: a pilot cluster randomised controlled trial. BMJ Open, 8, [e018563]. (doi:10.1136/bmjopen-2017-018563).

Record type: Article

Abstract

OBJECTIVE: Compassionate care continues to be a focus for national and international attention, but the existing evidence base lacks the experimental methodology necessary to guide the selection of effective interventions for practice. This study aimed to evaluate the Creating Learning Environments for Compassionate Care (CLECC) intervention in improving compassionate care.

SETTING: Ward nursing teams (clusters) in two English NHS hospitals randomised to intervention (n=4) or control (n=2). Intervention wards comprised two medicines for older people (MOP) wards and two medical/surgical wards. Control wards were both MOP’s.

PARTICIPANTS: Data collected from 627 patients and 178 staff. Exclusion criteria: Reverse barrier nursed, critically ill, palliative or non-English speaking. All other patients and all nursing staff and HCAs were invited to participant, agency and bank staff were excluded.
INTERVENTION: CLECC, a workplace intervention focused on developing sustainable leadership and work-team practices to support the delivery of compassionate care. Control: no educational activity.

PRIMARY AND SECONDARY OUTCOME MEASURES: Primary- Quality of Interaction Schedule (QuIS) for observed staff-patient interactions. Secondary- patient-reported evaluations of emotional care in hospital (PEECH); nurse-reported empathy (Jefferson Scale of Empathy).

RESULTS: Trial proceeded as per protocol, randomisation was acceptable. Some but not all blinding strategies were successful. QuIS observations achieved 93% recruitment rate with 25% of patient sample cognitively impaired. At follow-up there were more total positive (78% versus 74%) and less total negative (8% versus 11%) QuIS ratings for intervention wards versus control wards. Sixty-three percent of intervention ward patients scored lowest (i.e. more negative) scores on PEECH connection subscale, versus 79% of control. This was not a statistically significant difference. No statistically significant differences in nursing empathy were observed.

CONCLUSIONS: Use of experimental methods is feasible. The use of structured observation of staff-patient interaction quality is a promising outcome measure inclusive of hard to reach groups.

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Accepted/In Press date: 10 November 2017
e-pub ahead of print date: 22 February 2018

Identifiers

Local EPrints ID: 419009
URI: http://eprints.soton.ac.uk/id/eprint/419009
ISSN: 2044-6055
PURE UUID: a6835c40-7e92-4d2e-9088-37f14f5bc5fa
ORCID for Peter Griffiths: ORCID iD orcid.org/0000-0003-2439-2857
ORCID for Jackie Bridges: ORCID iD orcid.org/0000-0001-6776-736X

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Date deposited: 27 Mar 2018 16:31
Last modified: 17 Dec 2019 01:40

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Contributors

Author: Lisa J. Gould
Author: Peter Griffiths ORCID iD
Author: Hannah Barker
Author: Paula Libberton
Author: Ines Mesa-Eguiagaray
Author: Ruth Pickering
Author: Lisa, Jane Shipway
Author: Jackie Bridges ORCID iD

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