# Implementation of EIT-4-BPSD in Nursing Homes

> **NIH NIH R01** · UNIVERSITY OF MARYLAND BALTIMORE · 2020 · $314,878

## Abstract

Abstract
Behavioral and Psychological Symptoms of Dementia (BPSD) include aggression, agitation, depression,
anxiety, apathy and hallucinations and are exhibited by up to 90% of nursing home residents with dementia.
For residents, BPSD contribute to negative health outcomes, a decline in physical functioning, and may
increase the inappropriate use of antipsychotic drugs (AP) and physical restraints. BPSD also contribute to the
high cost of long term care. We, and other researchers, have shown that behavioral approaches can reduce
BPSD. The Centers for Medicare and Medicaid Services (CMS) in their National Partnership to Improve
Dementia Care and Reduce Antipsychotic Use in Nursing Homes has now focused regulatory efforts during
the nursing home survey on ensuring that care for residents with dementia is delivered using person-centered
behavioral approaches. Person-centered care is focused on collaborative partnerships among individuals,
their families and providers and emphasizes health and well-being by being responsive to an individual's
priorities, goals and needs. Unfortunately, less than 2% of nursing homes have implemented these changes.
The major barriers to use of behavioral approaches are limited knowledge, skills and motivation of staff to
utilize these approaches. The proposed research responds to the need to implement a person-centered
approach to management of BPSD by testing evidence-based practice for BPSD under conditions of an
implementation strategy referred to as the Evidence Integration Triangle (EIT). We worked with CMS to
advance the National Partnership and developed a comprehensive compendium of peer-reviewed/expert-
endorsed resources for utilizing person-centered, behavioral approaches to BPSD (i.e., a Nursing Home
Toolkit; nursinghometoolkit.com). To facilitate implementation of the person-centered behavioral management
of BPSD we merged the Toolkit and our previously tested 4-step approach as a way to overcome the barriers
to implementation. The steps include: Step 1. Assessment of the Environment and Policies; Step 2. Education
of Staff; Step 3. Establishing Person Centered Care Plans; and Step 4. Mentoring and Motivating of Staff) with
the EIT implementation strategy to develop the EIT-4- BPSD. We propose a cluster randomized trial with 50
nursing homes randomized to EIT-4-BPSD or Education Only (EO). Our aims are to: 1: implement and test
EIT-4-BPSD; and 2: evaluate use of the EIT strategy and our participatory implementation process with staff.
The findings from this study will add to what is known about implementation of effective interventions in nursing
homes, will serve as a model for other programs and care approaches, and will help facilities and staff
implement quality person-centered care, the ultimate goal of the National Partnership.

## Key facts

- **NIH application ID:** 9931305
- **Project number:** 5R01NR015982-05
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** ANN M KOLANOWSKI
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $314,878
- **Award type:** 5
- **Project period:** 2016-08-23 → 2021-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9931305

## Citation

> US National Institutes of Health, RePORTER application 9931305, Implementation of EIT-4-BPSD in Nursing Homes (5R01NR015982-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9931305. Licensed CC0.

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