ENRICHEnabling Research in Care Homes
Giving care homes the opportunity to be involved in research
Danielle Wilson, Interim Clinical Research Domain Lead, Cognitive Impairment and Dementia, Clinical Trials Facility Manager – West London Mental Health Trust
I first dipped my toe into the world of research almost 10 years ago when conducting a randomised control trial investigating infection control in care homes. We were specifically looking at MRSA infection rates in care homes, when MRSA was an extremely hot topic in the media.
I first dipped my toe into the world of research almost 10 years ago when conducting a randomised control trial investigating infection control in care homes. We were specifically looking at MRSA infection rates in care homes, when MRSA was an extremely hot topic in the media. On one hand we wanted to discuss with the care home manager about conducting research which would identify the rates of MRSA in their care home, something which understandably made some managers uncomfortable. Conversely, on the other hand, we were also offering training, support and information to assist homes to address both their rates of MRSA and their infection control processes in general to the group of care homes involved in the intervention arm of the study. We were also giving residents the opportunity to be involved in a research study which could improve infection control processes in the environment in which they lived, as well as the chance to see the researchers smiling faces each time they visited the care home!
We had several links to care homes including working closely with a ‘care home support team’ and the Principal Investigators’ professional links to care homes in the local area. We didn’t have a network as developed or as wide reaching as ENRICH which would have speeded up recruitment of care homes into this study. Through hard work, grit and determination we recruited twelve nursing homes and included six each in intervention (300 residents) and control (265 residents) groups.
At the start of the study we observed the hand hygiene facilities, environmental cleanliness and safe disposal of clinical waste which showed poor compliance in both groups. Post-intervention observations showed improvement in both groups and a greater awareness of how important these processes were. In both groups, greatest improvement was in compliance with safe disposal of clinical waste and the least improvement was in hand hygiene facilities.
Since infection control practice improved in intervention and control groups, we could not show a significant difference in homes that were involved in the intervention who received our package of training, versus care homes that didn’t receive the package of training. However, it appeared that by virtue of being involved in the research study and speaking with us, the researchers, about the aims of the study made the care home themselves re-assess their infection control processes and procedures, at a time where media interest was high. We also received feedback from care home staff, care home managers and residents indicating that they enjoyed the experience of being involved in a research study and the opportunity to have a ‘direct dial’ to a team of experts who they could ask for advice; we sensed a definite enthusiasm to take part in other studies!
The paper can be viewed at: http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=6103804&fileId=S0950268809002210
G.Gopal Rao, A.Jeanes, H.Russell, D.Wilson, E.Atere-Roberts, D.O’Sullivan, and N.Donaldson. Effectiveness of short term enhanced infection control support in improving compliance with infection control guidelines and practice in Nursing Homes: a cluster randomised trial. Epidemiol and Infect. 2009: doi:10.1017/S0950268809002210
Danielle Wilson now manages a clinical research facility at West London Mental Health Trust and leads research into Cognitive Impairment and Dementia. At the research facility patients, carers and healthy volunteers are involved in high quality research studies, where new treatments for dementia and other memory problems are specifically researched. Danielle can be contacted with any questions or queries at Danielle.firstname.lastname@example.org or on 020 8483 1823.