Co-design and testing of a digital educational intervention for care home nurses about heart failure

Background: Heart failure (HF) affects 20% of care home residents, contributing to high morbidity and mortality. This study aimed to co-design and test a digital intervention to improve care home nursing staff’s HF knowledge and self-efficacy, particularly for those without specialist HF training.<br/>Methods: A mixed-methods study was conducted in three phases:<br/>Theory Generation: A scoping review, conducted in accordance with PRISMA-ScR guidance, identified seven international studies on HF care education in nursing homes, revealing limited impact on resident outcomes and highlighting the complexity of implementation [1]. Seventeen qualitative interviews with care home staff and a Delphi study with 54 care home nurses further identified educational needs, emphasizing generalist knowledge and person-centered care [2]. The interviews also revealed a core theme: "It's fine until it's not," indicating struggles in recognizing early signs of HF deterioration in care home settings.<br/>Co-Design: Four co-design meetings with 15 stakeholders—including individuals with HF, HF professionals, and nursing home staff—used the insights from the theory generation phase to collaboratively develop the digital intervention, ensuring it addressed the specific needs identified [3].<br/>Feasibility Testing: Pre- and post-intervention assessments measured staff knowledge and self-efficacy using validated scales, and qualitative interviews explored staff experiences with the intervention.<br/>Results: Pre- and post-intervention assessments from 106 staff showed significant improvements (p&lt;0.01) in knowledge, self-efficacy, and confidence. Interviews with 14 care home nurses post-intervention revealed three key themes: 1) Learning: increased HF knowledge and symptom recognition, 2) Doing: practical applications of knowledge in monitoring and communication, and 3) Sharing: fostering a culture of continuous learning by sharing the intervention with colleagues.<br/>Conclusion: The co-designed digital intervention effectively enhanced care home staff’s HF knowledge and self-efficacy, leading to behavior changes and improved knowledge sharing. These findings suggest potential for better HF care quality in nursing homes, highlighting the need for further research to evaluate long-term resident outcomes and broader implementation strategies.<br/><br/>Abstract Summary: This study co-designed and tested a digital intervention to enhance care home staff's heart failure (HF) knowledge and self-efficacy. Using mixed methods, theory generation, stakeholder co-design, and feasibility testing, results showed significant improvements in staff knowledge, self-efficacy, and care practices. Findings suggest the intervention could improve HF care quality, warranting further research.<br/><br/>References: 1. McMahon, J, Thompson , DR, Cameron, et al. 2024, 'Heart failure in nursing homes: A scoping review of educational interventions for optimising care provision', International Journal of Nursing Studies Advances, vol. 6, 100178. https://doi.org/10.1016/j.ijnsa.2024.100178<br/>2. McMahon, J, Thompson , DR, Brown Wilson, C et al. 2024, 'Determining the key education priorities related to heart failure care in nursing homes: a modified Delphi approach', Healthcare, vol. 12, no. 15, 1546. https://doi.org/10.3390/healthcare12151546<br/>3. McMahon, J, Brown Wilson, C, Hill, L et al. 2023, 'Optimising quality of life for people living with heart failure in care homes: protocol for the co-design and feasibility testing of a digital intervention', PLoS One, vol. 18, no. 7, e0288433. https://doi.org/10.1371/journal.pone.0288433