Understanding Communication Between Rehabilitation Practitioners and Nurses: Implications for Post-Acute Care Quality

Informal Professional Communication of Rehabilitation Specialists and its Significance for their Practical Activities

Aim: To investigate the scope, forms and activeness of informal professional communication of rehabilitation specialists using information and communication channels and its significance for their practical activities. Materials and Methods: The following methods were used during the research: sociological; statistical; structural and logical analysis; generalization. Copies of the author’s original sociological survey questionnaire were used as research materials. Results: The analysis of the results of survey revealed that absolutely all interviewed rehabilitation specialists consider it useful to create virtual groups for professional communication with colleagues in the field of rehabilitation through modern information and communication channels. 44.9±3.7% of respondents recognized themselves as passive participants of such groups. But 98.9±0.8% of the survey participants consider the information received in such communication groups to be useful for professional clinical activities in the field of rehabilitation. It was determined that the issues of correct preparation of documentation when providing services under the packages of the National Health Service of Ukraine (78.7±3.1%) and the problems of organizing the provision of rehabilitation services in health care facilities (74.2±3,3) were discussed most often in the groups. Conclusions: The development of virtual professional communities of rehabilitation specialists helps them to exchange information and improve their knowledge in matters of organizing the provision of rehabilitation services in health care institutions and processing documentation. Provided that the facilitation of communication topics of professional groups is established, it is possible to improve their functioning and attract more specialists to active participation.

Implementation of the Frailty Care Bundle (FCB) to promote mobilisation, nutrition and cognitive engagement in older people in acute care settings: protocol for an implementation science study

Background: Older people are among the most vulnerable patients in acute care hospitals. The hospitalisation process can result in newly acquired functional or cognitive deficits termed hospital associated decline (HAD).  Prioritising fundamental care including mobilisation, nutrition, and cognitive engagement can reduce HAD risk. Aim: The Frailty Care Bundle (FCB) intervention aims to implement and evaluate evidence-based principles on early mobilisation, enhanced nutrition and increased cognitive engagement to prevent functional decline and HAD in older patients. Methods: A hybrid implementation science study will use a pragmatic prospective cohort design with a pre-post mixed methods evaluation to test the effect of the FCB on patient, staff, and health service outcomes.  The evaluation will include a description of the implementation process, intervention adaptations, and economic costs analysis. The protocol follows the Standards for Reporting Implementation Studies (StaRI). The intervention design and implementation strategy will utilise the behaviour change theory COM-B (capability, motivation, opportunity) and the Promoting Action on Research Implementation in Health Services (i-PARIHS). A clinical facilitator will use a co-production approach with staff. All patients will receive care as normal, the intervention is delivered at ward level and focuses on nurses and health care assistants (HCA) normative clinical practices. The intervention will be delivered in three hospitals on six wards including rehabilitation, acute trauma, medical and older adult wards. Evaluation: The evaluation will recruit a volunteer sample of 180 patients aged 65 years or older (pre 90; post 90 patients). The primary outcomes are measures of functional status (modified Barthel Index (MBI)) and mobilisation measured as average daily step count using accelerometers. Process data will include ward activity mapping, staff surveys and interviews and an economic cost-impact analysis. Conclusions: This is a complex intervention that involves ward and system level changes and has the potential to improve outcomes for older patients.