Plain English Summary
Background and study aims
Since nursing home residents are at substantial risk from COVID-19, nursing home care staff need to know what residents would want to happen should they become infected with COVID-19. The aim of this project is to develop and evaluate advance care planning COVID-centric online training and information resources for nursing home staff and family members to improve care at the end of life during a COVID-19 outbreak.
Who can participate?
Registered nurses and health care assistants working in nursing homes in the United Kingdom. Family members aged 18 years and older who are involved in the care of a resident in participating nursing homes.
What does the study involve?
This study involves the development and evaluation of an online COVID-centric advance care planning intervention. Findings from a rapid review of advance care planning resources will be used to develop the intervention for nursing homes. To evaluate the intervention, nursing home staff will be asked to participate in training and family members asked to review information via the online resource. Participants will be asked to take part in an interview prior to and 1-week following the implementation of the intervention.
What are the possible benefits and risks of participating?
Participating in this study may enhance knowledge and support advance care planning discussions in the context of COVID-19 with residents and their families. Participants may feel emotional. If this happens, participants can stop their involvement in the study at any point.
Where is the study run from?
Queens University Belfast (UK) is managing this study.
When is the study starting and how long is it expected to run for?
From June 2020 to August 2021.
Who is funding the study?
This project is co-funded by The Economic and Social Research Council (ESRC) as part of the UK Research and Innovation’s rapid response to COVID-19 and The Health and Social Care Research & Development Division (HSC R&D Division) of the Public Health Agency in Northern Ireland.
Who is the main contact?
Professor Kevin Brazil
k.brazil@qub.ac.uk
Study website
Contact information
Type
Scientific
Contact name
Prof Kevin Brazil
ORCID ID
http://orcid.org/0000-0001-7669-4991
Contact details
Queens University Belfast
Medical Biology Centre
97 Lisburn Rd
Belfast
BT9 7BL
United Kingdom
+44 (0)28 9097 5782
k.brazil@qub.ac.uk
Type
Public
Contact name
Prof Kevin Brazil
ORCID ID
Contact details
Queens University
Belfast
Medical Biology Centre
97 Lisburn Rd
Belfast
BT9 7BL
United Kingdom
+44 (0)28 9097 5782
k.brazil@qub.ac.uk
Additional identifiers
EudraCT/CTIS number
Nil known
IRAS number
286725
ClinicalTrials.gov number
Nil known
Protocol/serial number
IRAS 286725
Study information
Scientific title
Necessary discussions: Advance care planning for nursing homes in a COVID-19 outbreak
Acronym
Study hypothesis
One way of ensuring that care reflects residents wishes and preferences is to develop an advance care plan. However, critical gaps have been highlighted in research, policy and practice around advance care planning tools, training, and information resources.
The aim of this project is to develop and evaluate an online advance care planning COVID-centric resource for nursing homes during a COVID-19 outbreak to improve care at the end of life.
Ethics approval(s)
Approved 08/12/2020, Health and Social Care Research Ethics Committee B (HSC REC B, ORECNI office, Lissue Industrial Estate West, Rathdown Walk, Moira Road, Lisburn, BT28 2RF; +44 (0)28 95361400; RECB@hscni.net), ref: 20/NI/0173
Study design
Multicenter prospective case study design
Primary study design
Interventional
Secondary study design
Non randomised study
Study setting(s)
Internet/virtual
Study type
Quality of life
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet
Condition
Care at the end of life during a COVID-19 outbreak
Intervention
An online educational intervention for nursing home staff and family members on advance care planning during a COVID-19 outbreak will be developed. An expert reference group will advise on all aspects of the project and findings from a rapid review of advance care planning resources will be used to develop the intervention.
The intervention will be implemented in three locations across the UK (N. Ireland; England & Scotland). Up to three nursing homes in each location will be recruited. Up to five staff members in each nursing home will complete online training on advance care planning during a COVID-19 outbreak. The training will include the following six units:
1. An introduction to advance care planning in the context of a COVID-19 outbreak
2. Advance care planning in the context of a COVID-19 outbreak
3. How to complete an Advance Care Plan during a COVID-19 outbreak
4 Recording and sharing Advance Care Plans during a COVID-19 outbreak
5. Finding the words: Tips for having necessary discussions
6. Caring for yourself during a COVID-19 outbreak
Family members will review online information on advance care planning during a COVID-19 outbreak, including
1. What is advance care planning?
2. Why is advance care planning important?
3. What might be included in an advance care plan?
4. Who takes part in advance care planning
5. How do I take part in an advance care pla
6. Caring for myself during COVID-19.
Environmental scan interviews will be conducted before the intervention is implemented to identify characteristics and potential barriers and facilitators to implementation. Follow-up interviews will be carried out 1-week post intervention to explore the acceptability of the intervention and its impact.
Intervention type
Behavioural
Primary outcome measure
Acceptability of advance care planning COVID-centric online training resources and information for nursing home staff and family members measured using interviews carried out 1-week post-intervention
Secondary outcome measures
1. Barriers and facilitators to implementing an online educational intervention on advance care planning during a COVID-19 outbreak will be measured during pre-intervention interviews
2. The proportion and representativeness of identified nursing home staff and family members who access the online information and the features viewed will be measured using google analytics
3. Impact on knowledge and attitudes towards advance care planning will be explored using feedback forms and post-intervention interviews
4. Intention to participate in advance care planning conversations during a COVID-19 outbreak will be measured during post intervention interviews
Overall study start date
08/06/2020
Overall study end date
31/08/2021
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Nursing home staff: Registered nurse or health care assistant.
2. Family members: Aged 18 years or older; Be the individual most involved in the care of the resident; Have access to digital resources.
Participant type(s)
Mixed
Age group
Adult
Lower age limit
18 Years
Sex
Both
Target number of participants
Up to 45 nursing home staff and up to 54 family members
Total final enrolment
54
Participant exclusion criteria
1. Under 18 years of age
2. Do not have access to digital resources
Recruitment start date
18/02/2021
Recruitment end date
14/06/2021
Locations
Countries of recruitment
Northern Ireland, United Kingdom
Study participating centre
Queens University Belfast
University Road
Belfast
BT7 1NN
United Kingdom
Sponsor information
Organisation
Queen's University Belfast
Sponsor details
University Road
Belfast
BT7 1NN
Northern Ireland
United Kingdom
+44 (0)28 9024 5133
researchgovernance@qub.ac.uk
Sponsor type
University/education
Website
ROR
Funders
Funder type
Research council
Funder name
The Economic and Social Research Council as part of the UK Research and Innovation's rapid response to COVID-19
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Funder name
The Health and Social Care Research & Development Division (HSC R&D Division) of the Public Health Agency in Northern Ireland
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Funder name
Economic and Social Research Council
Alternative name(s)
ESRC
Funding Body Type
government organisation
Funding Body Subtype
National government
Location
United Kingdom
Funder name
Public Health Agency
Alternative name(s)
PHA
Funding Body Type
private sector organisation
Funding Body Subtype
Other non-profit organizations
Location
United Kingdom
Results and Publications
Publication and dissemination plan
Planned publication in a high-impact peer-reviewed journal.
Intention to publish date
31/08/2022
Individual participant data (IPD) sharing plan
The current data sharing plans for this study are unknown and will be available at a later date
IPD sharing plan summary
Data sharing statement to be made available at a later date
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol article | 09/08/2022 | 15/08/2022 | Yes | No | |
| Results article | 13/05/2022 | 15/08/2022 | Yes | No | |
| HRA research summary | 28/06/2023 | No | No |