Expand-Care - Expanded nursing competencies to improve person-centred care for nursing home residents with complex health needs: exploratary cluster-randomised controlled trial

Background

The care needs of older people in inpatient long-term care are becoming more complex due to multimorbidity and chronic diseases. Unplanned hospital admissions are common in this target group. Nursing professionals with bachelor's level qualifications can improve the quality of care, but Germany still lacks suitable role profiles for this.

Objective
To develop and evaluate a new role profile for nurses with expanded competencies to improve care for residents with complex health needs in long-term care.

Methods
An exploratory, cluster-randomised study was conducted in two phases:

Phase 1 – Intervention Development
A participatory approach was used to design the intervention, guided by the Medical Research Council (MRC) framework for developing and evaluating complex interventions and the PEPPA framework (Bryant-Lukosius et al., 2004). Stakeholders were involved in the co-development process to ensure practical relevance and feasibility of the new role profile.

Phase 2 – Pilot Study
The intervention was implemented and evaluated in an exploratory cluster-randomised controlled pilot study involving 11 long-term care facilities located in the Lübeck and Hamburg regions. The evaluation included both a health economic assessment and a process evaluation to explore feasibility, acceptability, and preliminary effectiveness.