Dental care and oral hygiene are often neglected in nursing homes. This study examines the effect of an education program on the ability of nursing staff to conduct an oral health assessment for a population of persons with Alzheimer's disease and related disorders. The findings of this study showed that the CNA's are as capable as the Licensed Nurses in assessing oral health status. In future training of nursing staff, increased emphasis on identification of problems in specific areas may improve the overall assessments by nurses and nursing assistants.
BackgroundAn increase in the complexity of patient's admitted to the Hospice and a greater use of acute interventions had resulted in staff feeling“too busy to care”with less time to provide high quality care.We recognised the need to change working practices to improve patient experience and staff satisfaction. After reviewing possible models and undertaking a scoping exercise, we agreed to implement the NHSReleasing Time to Care: The Productive Ward as a recognised quality initiative. This was previously restricted to hospital and community use, designed to help teams review working practices and minimise inefficient systems. This was supported at Network level in collaboration with 5 other Hospices.AimsIncrease Time for Caring therefore improving patient experienceImprove departmental/inter-departmental communicationImprove patient /staff environmentImprove staff satisfactionApproach usedNetwork supportEnhanced team workingStaff and senior management commitmentCollaborative module implementation trainingPhased roll outEvaluation at steering group levelOutcomesConfirmed network funding in conjunction with other hospicesNetwork training and support to empower staffFocus on collaborative approach, shared learning experience, making a wider impact than working in isolationTransparent care provision using quality measuresEfficient staff working practicesCost effectiveness, efficient use of limited resourcesImprovement in communication across all services and local hospicesAwareness of the importance of environment; little wins to improve patient care have a positive effect on staff moraleImproved patient safety and standard of care evidenced by quality measuresBenefit at local, organisational and network levelApplication to Hospice PracticeImproved collaboration and networkingUseful toolkit that has impacted on time for caring making a difference to patient experience and staff satisfactionTransferabilitySupports integrated working
Background More and more people are living with chronic disease near the end of their life, therefore palliative care needs are increasing. Outcome measurement has a major role to play in improving the quality, efficiency and availability of palliative care.Aim To capture what patients think about the impact of care on quality of life and their major concerns and on key symptoms. Method Patients were invited to participate in a 6-month pilot using the St Christopher's Index of Patient Priorities (SKIPP) questionnaire within the Hospice, Day Care and Community Macmillan Nurse Team.Data was collected and analysed using the recognised tool from St Christopher's Hospice. Results Findings from this pilot would suggest that patients did benefit from input from the Hospice, Day Care or Community Macmillan Nurse Team and identified a positive shift in how things were going for patients over a period of time. Though the number of patients was small and there were some patients who were unable to complete the questionnaire in full, there was still significant evidence to suggest a positive impact on patients' quality of life, key symptoms and major concerns. Discussion It is recognised that obtaining valid and reliable measurement of the outcomes achieved by palliative care for patients is extremely challenging often because patients are too ill or because of fluctuating and changing needs. However the questionnaire takes account of response shift, a well known phenomenon in which a persons' perception of subjective sensations can change over time. Conclusion Having a tool such as SKIPP has been deemed a very useful way of evaluating the impact three areas within Specialist Palliative Care have on a patients quality of life, key symptoms and major concerns. It is planned to repeat this exercise again for a 6 month period.
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