IDC-IMPROVE: protocol for a cluster randomised feasibility trial of a care bundle to improve indwelling catheter care (IDC) in residential aged care homes in Australia

IDC-IMPROVE:一项旨在改善澳大利亚养老院留置导尿管护理 (IDC) 的护理方案的整群随机可行性试验方案

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Abstract

BACKGROUND: Indwelling urinary catheters (IDCs) are used by approximately 8% of Australian aged care residents. IDC use is often warranted but entails numerous risks, particularly if used longterm. Risks include catheter-associated urinary tract infections, catheter blockage, catheter leakage, bladder spasm, pain, urethral trauma and haematuria, and increased risk of hospitalisation. The Royal Commission into Aged Care Quality and Safety identified poor quality, unsafe practices related to IDCs in aged care homes. Enhancing the knowledge, confidence, and skills of aged care staff to deliver catheter care for residents with IDCs is fundamentally important. The IDC-IMPROVE project is supporting aged care providers to meet the care needs of people with IDCs in Australian aged care homes, by designing and validating a suite of resources titled the IDC-IMPROVE Catheter Care Bundle. AIMS: This study aims to establish the feasibility of conducting a definitive randomised control trial to evaluate the effects of the IDC-IMPROVE Catheter Care Bundle in aged care homes in Australia. METHOD: A multi-centre, facility-level clustered randomised control (cRCT) feasibility trial in 24 aged care homes across Victoria, Queensland, and South Australia. Twelve homes will receive the intervention and 12 will continue usual care. The IDC-IMPROVE Catheter Care Bundle intervention comprises principles for person-centred catheter care, online training for nurses and personal care workers, a practical skills workshop for nurses, a toolkit for managers, and an evidence-to-practice support model. The feasibility of the intervention will be assessed through a mix of qualitative and quantitative methods, including surveys, interviews, and audits. Feasibility outcomes are: (i) The acceptability of the Bundle, (ii) The fidelity of the implementation, (iii) The compatibility of the Bundle with standard aged care home IDC care. DISCUSSION: By enhancing the knowledge, confidence and skills of the aged care workforce, IDCIMPROVE aims to reduce IDC-related complications. This study will provide insights into the acceptability and implementation of the intervention, informing future large-scale trials and potential policy changes. ETHICS: The study has been approved by Austin Health Human Research Ethics Committee (reg: HREC/107165/Austin-2024) and is registered on the Australian New Zealand Clinical Trials Registry (reg: ACTRN12624001178538p).

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