Implementation Lessons Learned: Distress Behaviors in Dementia Intervention in Veterans Health Administration.
Background and Objectives Evidence-based practices to manage distress behaviors in dementia (DBD) are not consistently implemented despite demonstrated effectiveness. The Veterans Health Administration (VA) trained teams to implement Staff Training in Assisted Living Residences (STAR)-VA, an interve...
| Publicado en: | Gerontologist Vol. 64; no. 2; pp. 1 - 16 |
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| Autores principales: | , , , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Feb2024
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=175259298&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 175259298 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00169013 GET jtl: Gerontologist issn: 00169013 maglogo: N pubinfo: dt: Feb2024 vid: 64 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 175259298 10.1093/geront/gnad060 ppf: 1 ppct: 15 formats: tig: atl: Implementation Lessons Learned: Distress Behaviors in Dementia Intervention in Veterans Health Administration. aug: au: Curyto, Kim Wray, Laura O Sullivan, Jennifer L McConnell, Eleanor S Jedele, Jenefer M Minor, Lisa Karel, Michele J affil: Center for Integrated Healthcare, VA Western NY Healthcare System , Batavia, New York , USA Center for Integrated Healthcare, Office of Mental Health and Suicide Prevention, VA Central Office , Buffalo, New York , USA Division of Geriatrics and Palliative Care, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo , Buffalo, New York , USA Center of Innovation in Long Term Services and Supports (LTSS COIN), Capt. Jonathan H. Harwood Jr Center for Research, VA Providence Healthcare System , Providence, Rhode Island , USA Department of Health Service, Policy and Practice, School of Public Health, Brown University , Providence, Rhode Island , USA Geriatric Research, Education and Clinical Center (GRECC) , Durham, North Carolina , USA School of Nursing, Duke University , Durham, North Carolina , USA Blue Cross and Blue Shield of North Carolina , Durham, North Carolina , USA Facility Based Care, Geriatrics and Extended Care (10NC4), VA Central Office , Washington, District of Columbia , USA Geriatric Mental Health, Office of Mental Health and Suicide Prevention, VA Central Office , Washington, District of Columbia USA su: United States Confidence Self-perception Human services programs Content analysis Psychological distress Treatment of dementia Research methodology Surveys Conceptual structures Independent living Health care teams Descriptive statistics Research funding Medical care of veterans sug: subj: Confidence Self-perception Human services programs Content analysis Psychological distress United States Administration of Veterans' Affairs Treatment of dementia Research methodology Surveys Conceptual structures Independent living Health care teams Descriptive statistics Research funding Medical care of veterans keyword: Implementation science Interdisciplinary Mixed methods Nursing homes Sustainment Implementation science Interdisciplinary Mixed methods Nursing homes Sustainment ab: Background and Objectives Evidence-based practices to manage distress behaviors in dementia (DBD) are not consistently implemented despite demonstrated effectiveness. The Veterans Health Administration (VA) trained teams to implement Staff Training in Assisted Living Residences (STAR)-VA, an intervention to manage DBD in VA nursing home settings, or Community Living Centers (CLCs). This paper summarizes multiyear formative evaluation results including challenges, adaptations, and lessons learned to support sustained integration into usual care across CLCs nationwide. Research Design and Methods STAR was selected as an evidence-based practice for DBD, adapted for and piloted in VA (STAR-VA), and implemented through a train-the-trainer program from 2013 to 2018. Training and consultation were provided to 92 CLC teams. Evaluation before and after training and consultation included descriptive statistics of measures of clinical impact and survey feedback from site teams regarding self-confidence, engagement, resource quality, and content analysis of implementation facilitators and challenges. Results STAR-VA training and consultation increased staff confidence and resulted in significant decreases in DBD, depression, anxiety, and agitation for Veterans engaged in the intervention. Implementation outcomes demonstrated feasibility and identified facilitators and barriers. Key findings were interpreted using implementation frameworks and informed subsequent modifications to sustain implementation. Discussion and Implications STAR-VA successfully prepared teams to manage DBD and resulted in improved outcomes. Lessons learned include importance of behavioral health–nursing partnerships, continuous engagement, iterative feedback and adaptations, and sustainment planning. Evaluation of sustainment factors has informed selection of implementation strategies to address sustainment barriers. Lessons learned have implications for integrating team-based practices into system-level practice. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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