RecruitingACTRN12622000773730

Nurse led volunteer support interventions and a technology driven pain assessment for older adults in hospital

Effectiveness of nurse led volunteer support interventions and a technology driven pain assessment for older adults in hospital

Sponsor

Edith Cowan University

Enrollment

200 participants

Start Date

Feb 2, 2022

Study Type

Interventional

Conditions

Clinical incidents Pain Extended hospital admission

Summary

Hospitalisation for older people can result in poor health outcomes, and this is more evident in frail older patients and those with cognitive impairment. Factors such as chronic health conditions, polypharmacy and cognitive and functional decline are associated with increased risk of health care related harm, (such as falls, delirium and poor nutrition) (George, Long, & Vincent, 2013). Pain is also very common in older adults in hospital, however assessment of pain in older patients in hospital can be impacted by the patient’s communication of pain which may be affected by their beliefs about pain as a normal part of ageing, concerns related to use of medications for pain, and cognitive impairment often resulting in under treatment of pain (Schofield et al, 2018). Assessing pain begins with a person’s self-report using pain assessment tools but this can be challenging in older patients, and technology driven pain assessments have been developed for better pain assessment. One such application is PainChek Universal® that enables better assessment of pain at the point of care for those whose ability to communicate fluctuates. PainChek Universal® contains 2 scales 1. Numerical Rating Scale (NRS) for those who can self-report their pain.2. The PainChek scale for those who cannot self-report their pain (using automated facial recognition and analysis to identify pain-related facial micro-expressions, together with a series of user completed checklists of pain behaviours (Atee et al. 2017; Atee et al. 2018a).To minimise the risk of health care-related harm, volunteer programs to support patient care have been established in many hospitals worldwide. Volunteer programs have shown a positive impact on older patients in hospital and have positively upon patient health outcomes related to nutrition, falls and delirium (Naylor et al. 2013; Saunders et al 2019). A non-randomized intervention study will evaluate a model of service delivery for older adults in hospital aged 65 years and older through implementation of technology driven pain assessment and a nurse-led volunteer support program.

Eligibility

Sex: Both males and femalesMin Age: 65 Yearss

Plain Language Summary

Simplified for easier understanding

Older adults in hospital face real risks beyond their original health problem — including falls, delirium, poor nutrition, and undertreated pain. Pain can be especially difficult to assess when someone has cognitive impairment, since they may struggle to describe how they're feeling. This study at a Perth hospital tests a new model of care that combines technology-assisted pain assessment with a nurse-led volunteer support program. The pain assessment technology used is PainChek Universal, a smartphone-based app that uses facial recognition to detect pain-related micro-expressions in people who can't self-report — offering a more objective way to spot and treat pain early. The volunteer program provides social connection, encouragement with eating, and supervision during activities to reduce falls and delirium risk. All patients aged 65 or older admitted to the geriatric medical wards at this Perth hospital are eligible. There are no exclusion criteria. The study is non-randomised — it evaluates outcomes before and after the new care model is introduced — and is run by Edith Cowan University.

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Interventions

All patients will have their pain assessed by nurses utilizing the PainChek® Universal and all patients will be offered one-to-one volunteer support across morning and afternoon shifts from Monday to Friday during their inpatient admission on the study wards at Joondalup Health Campus. Volunteer support consists of assisting patients with activities related to orientation, cognition, sensory, mobility (encouraging and walking with ambulant patients; encouraging the patient to complete exercises), nutrition ( encouraging the patient to eat, and assisting with the set-up of meals), and wellbeing support (such as providing hand and foot massage, hair brushing) the nurse The duration of the volunteer support will be recorded on the volunteer Support Care plan. For patients who are able to report their pain using the Numerical Rating Scale 0-10, nurses will assess the pain and record the outcome in PainChek® Universal application. For patients who are unable to report their pain using NRS the nurse will assess the patients pain using the PainChek application within PainChek Universal. Using AI, facial recognition and smartphone technology, PainChek® intelligently automates the pain assessment process at the point of care.