Study I The workshops (tentative plan) Groups of one-two nurse aides, one-two registered
nurses and one-two managers from the nursing homes in the intervention group will form a
workshop. In total, four-five workshops will be conducted. Each workshop will begin with
an introductory framing of the workshop followed by addressed activities in four
stations. The activities in the four stations are designed to give the participants
possibility to be active in order to develop the intervention. The participants will
write down conclusions of the discussions and the discussions will be audio recorded. The
written documentation and the recorded discussions will constitute data and will be
analyzed using content analysis.
Station one: the participants will discuss beforehand written questions based on the
results of our previous studies, and literature in order to stimulate reflection and
discussion. The participants will discuss how to work in a better/different way with risk
assessments, care interventions and follow-ups that can contribute to improve the
preventive work so that older persons are risk assessed, get the right care interventions
planned, performed and evaluated to a greater extend. They will also discuss how the
organization/routines around the preventive care process be developed. The participants
will write down conclusions of the discussion.
Station two: the participants will discuss beforehand written questions concerning the
preventive care process according to Senior Alert. The participants will work creatively
to identify barriers and challenges in the preventive care process according to Senior
Alert and how this process could be done in a smoother way. The participants will write
down conclusions of the discussion.
Station three: the participants will discuss how the intervention could be design. Focus
of the discussion will be on the core components of the intervention, e.g. context,
activity, participants, time required and implementation. The participants will write
down the discussion.
Station four: summary of the workshop.
The intervention (tentative plan) The intervention will be written out in detail after
the workshops have been conducted, but below is a short description in accordance with
the one in the Ethical approval.
The content of the intervention will focus on the importance of prevention of the risk
for pressure ulcers, malnutrition, poor oral health and falls among older persons in
nursing homes and the preventive process in accordance with Senior Alert. The
intervention could consist of; a work sheet to facilitate clinical decisions, new way of
working, educational support, films or lectures, to meet nurse aides´, registered nurses´
and managers´ educational needs, fit into their organization and facilitate the
preventive nursing care regarding these health risks.
Study II Feasibility/pilot testing the intervention The most suitable method will be
applied to test and evaluate the intervention. A feasibility study could be carried out
to evaluate if there are any uncertainties around the recruitment, data collection and
retention or the intervention itself around the optimal content, delivery and
acceptability. A pilot study could be carried out to address the main uncertainties in
the development work and to indicate if further evaluation should be preceded or the
intervention needs to be refined.
Evaluating the intervention To evaluate primary outcome measures, register data is going
to be extracted from Senior Alert six months prior and one and six months after the
intervention. Data on risk assessments and preventive interventions from the instruments
available in Senior Alert (described in our previous studies) will be extracted.
Additionally, background data regarding older persons in terms of biological sex, age and
type of health care setting will be gathered from the registry.
Descriptive and analytic analysis will be performed in IBM SPSS Statistics Windows,
Version 25 (Armonk, NY: IBM Corp) for comparisons between and within the intervention and
control group.
To evaluate secondary outcome measurers all the nurse aides and registered nurses working
in all the nursing homes included (both the intervention and the control group) will be
invited to fill in questionnaires: the Psychosocial Aspects of Job Satisfaction
questionnaire, the Perceived Stress Scale stress and the Stress of Conscience
Questionnaire, at baseline (prior to the workshops) and six months after the
intervention. Background data as age, gender, years of work experience and educational
level will be collected. For comparisons between and within the intervention and control
group before and after tests will be performed. IBM SPSS Statistics for Windows, Version
25 (Armonk, NY: IBM Corp) will be used to calculate descriptive and analytic statistics.