Page 105 - Demo

Implementation interventions through the lens of Normalisation Process Theory1034Table 2. continuedProfessional implementation interventionsDescription by Cochrane EPOC review group (2002)Description of adaptations of professional implementation interventions for MDETCodeEducational outreach visitsUse of a trained person who met with providers in their practice settings to give information with the intent of changing the provider%u2019s practice. The information given may have included feedback on the performance of the provider(s). Note: The word %u2018visit%u2019 has been omitted due to the fact that Educational Outreach can have other forms as well (phone, e-mail etc.). In educational outreach general (G) background information is given about additional psychiatric or behavioural problems occurring in people with intellectual disabilities, such as anxiety, autism, attachment, PTSD, challenging behaviour and applied restrictive measures. This kind of educational outreach aims to enhance the level of knowledge and understanding of support staff. EO-GThe expert asks questions about behaviour or standard treatment of an individual resident based on his experience and knowledge. The expert provides educational outreach by proposing a specific treatment (T) intervention for an individual resident. EO-TLocal opinion leadersUse of providers nominated by their colleagues as %u2018educationally influential%u2019. The investigators must have explicitly stated that their colleagues identified the opinion leaders. Local professionals who have a significant influence on the care team. For example a team leader, a caregiver with substantial expertise, the behavioural consultant, physician or manager. These professionals are often involved in taking decisions and explaining these to their care team.LOLPatient mediated interventions New clinical information (not previously available) collected directly from patients and given to the provider e.g. depression scores from an instrument. Note: In Dutch long-term care people with intellectual disabilities are not seen as patients, but referred to as clients. People with intellectual disabilities often have difficulty speaking for themselves. Relatives and personal caregivers act as proxies. Therefore, we renamed this intervention to client-related interventions. Descriptions of the restrictive measures in client%u2019s personal files or in notes of discussions about the meaning of client%u2019s behaviour leading to the use of restrictive measures or the effects of treatment interventions on residents behaviour.CRI