A quasi-experimental study on the effectiveness and impact of implementing nurse-led ‘Therapeutic Optimisation’ (THEO) intervention in two older persons wards: A mixed methods study protocol

ATAIYERO, Yetunde; DUBE, Alisen; Odell, Joanne; Carter, Vanda; SMITH, Hazel; Hardy, Sally; Leary, Alison; JONES, Sarahjane

Abstract or description

Introduction
Higher staffing levels, particularly with experienced registered nurses, are associated with improved patient safety and fewer adverse events, as skilled nurses can quickly identify potential risks and implement strategies to mitigate them, creating a safer environment for patients. This study will investigate the effectiveness and impact of implementing Therapeutic Optimisation (THEO) intervention, a complex intervention aimed at enhancing nursing care by increasing experienced registered nurse staffing and facilitating practice development activities for all staff.

Methods and Analysis
A multi-centre quasi-experimental (before and after) study with an embedded convergent mixed methods process evaluation in older persons’ wards across two NHS Trusts in England. Four work packages are proposed. Work Package 1 will use Participatory Action Research to implement the THEO intervention, including an enhanced staffing model and practice development activities, involving seven iterative participatory data collection exercises with staff, patients, and their personal consultees, as appropriate. Work Package 2 will extract and aggregate anonymised administrative data (patient and staff-related) from January 1, 2015, to 30 days after the 12-month intervention period. Work Package 3 will use qualitative interviews to explore the experiences of patients with and without mental capacity (with their personal consultees) and staff regarding the THEO intervention. Work Package 4 is a mixed methods process evaluation to assess implementation and contextual factors impacting the effectiveness of the THEO intervention, collecting both quantitative (survey) and qualitative (guided discussions and workshops) data.

Ethics and Dissemination
The UK Health Research Authority provided governance and ethical approval (IRAS ID: 334473). Dissemination will be with key stakeholders (including patient and public representatives), conference presentations and publications in peer-reviewed high impact journals.

Item Type:

Article

Additional Information:

Strengths and Limitations of this Study • This study combines a quasi-experimental design with an embedded convergent mixed methods process evaluation to explore both outcomes and implementation processes. • It employs Participatory Action Research to support inclusive, practice-based implementation and co-production of knowledge with healthcare professionals. • The study incorporates both staff and patient perspectives, including those with limited mental capacity, using ethical and context-sensitive methods. • The embedded nature of the intervention across two different NHS Trusts allows for real-time learning but may introduce variability in implementation fidelity. • Findings may have limited transferability beyond older persons’ wards, as the study is situated in a specific care context and population.

Uncontrolled Keywords:

Nursing Care, Patient Outcomes, Participatory Action Research, Practice Development, Staff Outcomes, Therapeutic Optimisation

Faculty:

School of Health and Social Care > Nursing and Midwifery

Depositing User:

Yetunde ATAIYERO

Date Deposited:

02 Sep 2025 13:40

Last Modified:

02 Sep 2025 13:40

URI:

https://eprints.staffs.ac.uk/id/eprint/9175