“Nursing home residents are more than 1.4 times greater at risk of emergency admission and have more than 50% more unplanned hospital admissions compared to the general population aged >75 years. Unplanned hospital admissions cost the UK NHS >£11 billion, US healthcare economy >$1.1 trillion/year and account for more than a third of admissions each year. Evidence suggests that many nursing home residents’ hospitalisations can be avoided through rapid detection and timelier treatment.

Decision support tools, which provide a systematic approach to monitoring non-specific cognitive and behavioural changes, provide an opportunity to improve early and consistent detection to infection detection, prompt action and treatment, thus minimising transmission, reducing antibiotic prescribing, emergency hospital admissions, and distress experienced by nursing home residents when moved to an unfamiliar environment.

Robust tools are used in acute care settings for early identification of deterioration but are not commonly developed for use in residential care or always suitable for use by those providing care in this setting i.e., care workers.

Designed for completion by Swedish care workers, who have the most direct contact with residents and tend to be the first people to identify change in psychological and or cognitive behaviour , the Early Detection of Infection Scale is a brief tool that includes assessment of body temperature, using a new approach based on difference from baseline, the so-called ‘DiffTemp’ instead of pre-decided values for fever i.e. >38°C, offering a more targeted approach focusing on specific aspects of behaviour and functional status.

Early reports of using the Early Detection of Infection Scale in practice are positive, with users reporting high levels of acceptability. However, as the Early Detection of Infection Scale is still undergoing ongoing development, it is yet to be to be widely adopted in Sweden.

Given ensuring quality and cost-effectiveness is an increasingly essential requirement of service delivery, development and field-testing of an English version of the Early Detection of Infection Scale for use by nurses and care workers in nursing/care homes in the UK and other countries is urgently required.

Working in collaboration with stakeholders, an established patient public involvement group and wider international EDI group this studentship will develop an English version of the Early Detection of Infection Scale (EDIS) for nurses and care workers to use with nursing home residents. Initial feasibility and acceptability in Scotland will be explored, providing preliminary estimates on hospital admissions, infection rates, antibiotic prescribing, mortality, care processes and needs, staff knowledge, and confidence in infection detection.

You will work alongside researchers from the Department of Nursing and Midwifery, at UHI. Your Director of Studies will be Nicola Carey, Professor of Health Services Research (Head of Department) and your second supervisor Dr Michelle Beattie (Senior Lecturer). You will be supported by a third supervisor, Dr Megan Dickson (Lecturer).

This project will involve mixed methods research and also working closely with stakeholders across the Highlands and Scotland.

We are looking for a student who feels passionately about conducting research with older adults, with excellent communication skills, experience in quantitative and qualitative research methodologies who is interested in older people and developing research in nursing homes.

Applicants should normally have:

• A postgraduate Master’s degree from a degree-awarding body recognised by the UK government, or equivalent, or
• A first or upper second-class honours degree from a degree awarding body recognised by the UK government, or equivalent, or
• Other qualifications or experience that affords sufficient evidence of an applicant’s ability to work at the academic level associated with doctoral study.
• Good communication skills
• Experience in quantitative and qualitative research
• Interest in research in older people

The start date of this project is: 2 October 2023″