Page 102 - Demo

Chapter 4100Adaptations of EPOC%u2019s interventions to describe the implementation of MDET Developing the adaptations in EPOC%u2019s professional implementation interventions (Table 2) was an iterative process. The intervention Distribution of educational materials (DEM) according to EPOC involves published or printed recommendations for clinical care, to stimulate behavioural change. The data revealed that within the implementation of MDET, multiple stakeholders received information letters about MDET and the effectiveness trial. This led to the start of implementation. Therefore, we added a new subcategory Distribution of information materials (DIM).The intervention educational outreach visits focuses on meetings of trained persons with caregivers in their working practice to give information and change practice. Because educational outreach may be done in person, online or by phone, we abbreviated this label to educational outreach (EO). Two subtypes were recognised. The intervention described as %u2018educational outreach-general%u2019 (EO-G) aimed at increasing care staffs insights in background of challenging behaviour among people with intellectual disabilities. The intervention described as %u2018educational outreach-treatment interventions%u2019 (EO-T) involved experts proposing a treatment for one client to reduce restrictive measures.Patient-mediated interventions in EPOC focuses on new clinical information collected directly from patients and given to the provider. Two adaptations were made: First, within the Dutch context of long-term care, residents are not seen as %u2018patients%u2019. They are called %u2018clients%u2019. Second, the %u2018mediated%u2019-part is complicated in care for people with intellectual disabilities because some may have difficulty speaking for themselves. Representatives such as parents or siblings, and in this research mainly personal caregivers, spoke on behalf of their clients. Therefore, we renamed this implementation intervention as client-related interventions (CRI). At the organisational level this intervention involved the systematic recordings of restrictive measures in client files, supporting the need to implement methods such as MDET to comply with the Care and Coercion Act. At the client level CRI was recognised in obtaining descriptions of the forms of restrictive measures