Improving nursing practice in primary care through audit and feedback: A pilot study
| ISRCTN | ISRCTN17789420 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN17789420 |
- Submission date
- 03/10/2019
- Registration date
- 05/11/2019
- Last edited
- 01/11/2019
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
There is only little performance measurement of nursing care due to limited access to data. Although audit and feedback (A&F) interventions show favorable results on performance improvement, its effectiveness and some of its components are poorly understood. This pilot study aims to evaluate the feasibility and preliminary effectiveness of an A&F intervention with a nursing team in a local community health center in Quebec, Canada.
Who can participate?
The nursing team in a local community health center in Quebec, Canada
What does the study involve?
Performance is measured through 7 nursing-sensitive indicators using clinical and administrative data from the I-CLSC database and based on episodes of wound care. Indicators include continuity, nursing follow-up, initial assessment, teaching and frequency of consultations. Data are collected once (T1), then after 6 (T2) and 12 months (T3). The feedback sessions are led by a clinician acquainted with this nursing team
What are the possible benefits and risks of participating?
The possible benefits of participating are an improvement of organizational and clinical aspects of care, which could lead to an increase of job satisfaction. The possible risks are to feel incompetent or frustrated regarding negative results with the indicators measured. We aim at reducing these risks by measuring and reporting the indicators at a team level rather than at an individual level so as no participant feels singled out. The participants are also invited to express their feelings on the results so that any frustration can be verbalized and discussed within the team
Where is the study run from?
A local community health center in Quebec, Canada
When is the study starting and how long is it expected to run for?
September 2017 to December 2019
Who is funding the study?
Réseau de recherche portant sur les interventions en sciences infirmières du Québec (Quebec Network on Nursing Intervention Research)
Who is the main contact?
Émilie Dufour
emilie.dufour.3@umontreal.ca
Contact information
Scientific
Faculty of Nursing
Université de Montréal
C.P. 6128 succ. Centre-Ville Montréal Marguerite-d’Youville Campus
Montréal
H3C 3J7
Canada
 ORCID ID |
0000-0001-5234-5500 |
|---|---|
| Phone | 514 343-6437 |
| emilie.dufour.3@umontreal.ca |
Study information
| Study design | Quasi-experimental |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Non randomised study |
| Study setting(s) | Community |
| Study type | Other |
| Participant information sheet | Not available in web format, please use the contact details below to request a patient information sheet |
| Scientific title | Implementation and evaluation of an audit and feedback intervention to improve nursing practice in primary care |
| Study objectives | There is only little performance measurement of nursing care due to limited access to data. Although audit and feedback (A&F) interventions show favorable results on performance improvement, its effectiveness and some of its components are poorly understood. This pilot study aims to evaluate the feasibility and preliminary effectiveness of an A&F intervention with a nursing team in a Local community Health Center in Quebec, Canada |
| Ethics approval(s) | Approved 06/09/2019, Comité d’éthique de la recherche en santé de l’Université de Montréal (C.P. 6128 succ. Centre-ville Montréal, QC H3C 3J7, Canada; +1 514-343-6111 (2604); ceres@umontreal.ca), ref: 17-127-CERES-D |
| Health condition(s) or problem(s) studied | Wound care in nursing practice |
| Intervention | Seven nursing-sensitive indicators were measured using clinical and administrative data and based on episodes of wound care. Indicators were measured from an electronic system that provides information on primary care users and the services delivered to them. Nurses are required to record their interventions in that system using a preset code bank in addition to writing a note in medical charts. The study was conducted in a Local community Health Center in Quebec, Canada. The indicators were collected once (T1), then after 6 (T2) and 12 months (T3). Participation was spread out over the course of 18 months. Scores for all indicators were reported in two feedback sessions with clinicians and managers. The feedback sessions were led by a clinician acquainted with this nursing team. The indicators were displayed in graphs and short sentences that provided a summary of key elements. Following the reporting of the indicators, the team was asked to reflect and discuss on the results so that they could identify concrete actions for improving these indicators. The objectives and associated actions were written down on a scoreboard |
| Intervention type | Behavioural |
| Primary outcome measure | Performance is measured through 7 nursing-sensitive indicators using clinical and administrative data from the I-CLSC database and based on episodes of wound care. We measure the change from baseline performance at 6 and 12 months based for those 7 indicators. 1. Continuity: Percentage of care episodes in which at least 50 % of the consultations are provided by the same professional 2. Planning and adjusting of the treatment plan: Percentage of care episodes in which at least 75 % of the consultations are with an RN 3. Education: Percentage of care episodes in which at least one education session is provided 4. Initial assessment: Percentage of care episodes in which an RN performs a wound assessment in the first consultation 5. Frequency: Percentage of care episodes with no more than three consultations per week as of the second week 6. Duration: Percentage of care episodes lasting 42 days or less 7. Intensity: Percentage of care episodes with no more than 22 consultations |
| Secondary outcome measures | None |
| Overall study start date | 15/05/2017 |
| Completion date | 31/03/2020 |
Eligibility
| Participant type(s) | Health professional |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | One nursing organization and data from about 400 episodes of wound care from patients at each measurement time |
| Key inclusion criteria | 1. Nursing organization that offers services seven days a week will be included so that they can measure all the selected indicators and use the I-CLSC software in their daily practice 2. Wound care episodes with a minimum duration of 7 days and an episode start during the measurement period will be included. These two criteria are applied in order to measure all seven indicators |
| Key exclusion criteria | 1. Wound care episodes in palliative care will be excluded, as the indicators were selected for episodes of wound care with healing potential |
| Date of first enrolment | 01/09/2017 |
| Date of final enrolment | 31/12/2019 |
Locations
Countries of recruitment
- Canada
Study participating centre
Canada
Sponsor information
University/education
2375, chemin de la Côte-Ste-Catherine
Montréal
H3T 1A8
Canada
| Phone | information@scinf.umontreal.ca |
|---|---|
| emilie.dufour.3@umontreal.ca | |
"ROR" |
https://ror.org/0161xgx34 |
Funders
Funder type
Research organisation
Private sector organisation / Other non-profit organizations
- Alternative name(s)
- Quebec Network on Nursing Intervention Research, Réseau RRISIQ Network, Réseau de recherche en interventions en sciences infirmières du Québec, RRISIQ
- Location
- Canada
Results and Publications
| Intention to publish date | 30/12/2019 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not expected to be made available |
| Publication and dissemination plan | Planned publication in a high-impact peer-reviewed journal. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study are not expected to be made available due to ethical restrictions |
Editorial Notes
01/11/2019: Trial’s existence confirmed by Réseau de recherche portant sur les interventions en sciences infirmières du Québec
