Sunday, June 20, 2021

World-first trial to improve outcomes for frail patients

A world-first trial investigating the effects of nurse-led volunteer support and pain assessment technology could lead to improved outcomes for patients in hospital who are frail.

The two-year Nurse-led Volunteer Support and PainChek Frailty Study involves more than 700 patients at WA’s Hollywood Private Hospital.

It is the first clinical trial to compare changes in frailty for hospital patients who receive nurse-led volunteer support and pain assessment (using high-tech smartphone app PainChek Universal®) to those who receive standard care.  

Volunteers will help patients with orientation, eating, drinking, exercising and walking. They will also provide sensory support and social and cognitive stimulation through conversation, reading, word games and other activities. 

Edith Cowan University Centre for Research in Aged Care researcher, Dr Rosemary Saunders, said patients in hospitals were getting older and there was the potential for poorer health outcomes particularly if the patient was frail.

“Frailty is the process of physical decline associated with aging – there is an increased risk of harm, such as falls, delirium and poor nutrition,” Dr Saunders said.

“Pain also increases with age.”

Dr Saunders said pain assessment can be challenging among elderly patients who cannot verbalise their pain, such as those with dementia.

“This can put these patients at risk of poor pain management increasing their vulnerability to frailty,” Dr Saunders said.

The study will investigate the impact of using PainChek Universal on reducing frailty. PainChek uses artificial intelligence (facial recognition and analysis) and smart automation to provide accurate pain assessment.

It is the first time PainCheck Universal has been used in a hospital in the world.

PainChek Chief Scientific Officer, Prof Jeff Hughes said the study is a great opportunity to evaluate the impact of technology on the progression of frailty associated with hospital admissions.

“Acknowledging that frailty is often the result of multiple contributors, it is hoped the use of PainChek Universal will facilitate better pain control, hence mitigating its contribution to frailty,” Prof Hughes said.

As part of the nurse-led volunteer support, a team of 30 volunteers have been trained and a project nurse will develop an individual volunteer support plan for each patient. 

Volunteers will interact one-on-one with patients and provide support up to two-hour sessions daily under the guidance of the project nurse.

Trial patients will be assessed on admission, at discharge and at 30 days after discharge.

“We will evaluate these interventions, in addition to patient, family and staff experiences as well as cost effectiveness,” Dr Saunders said.

Patients in acute care are being recruited for the study, which is expected to be completed in December 2022.

The project is a collaboration between researchers from Hollywood Private Hospital, Edith Cowan University, Centre for Research in Aged Care, School of Nursing and Midwifery and four universities around Australia. 

Hollywood Private Hospital’s Director of Clinical Services, Karen Gullick said research was important for improving patient outcomes.

“We hope the findings of this research will be applied in practice to provide volunteer support and better pain assessment and management,” Ms Gullick said.

“By developing new knowledge we can make a real difference in the lives of patients, their families and medical staff.”

The frailty project was made possible through a $734,000 grant from the Ramsay Hospital Research Foundation.

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