Fundamental care for people with cognitive impairment in the hospital setting: A study combining positive organisational scholarship and video‐reflexive ethnography

Abstract

Aims and objectives:To clarify how high-quality fundamentals of care for people with dementia and/or delirium were practised in a specialist geriatric evaluation and management unit.Background: Older people with cognitive impairment represent a significant number of people who are admitted to hospital. They are at increased risk of dying, readmission and long hospital stays, relative to those without cognitive impairment. There is an urgent need to elucidate the conditions that underpin safe and high-quality fundamental care for these patients and their families. Methods:Using the innovative methodologies of positive organisational scholarship in healthcare and video-reflexive ethnography, this 18-month study was conducted within an inpatient geriatric evaluation and management unit for people with dementia and/or delirium in South Australia. Patients, family members and staff members (managerial, clinical and nonclinical) participated by allowing researchers to document ethnographic fieldwork notes and film their practices and/or accounts thereof; and/or interpreting digital recordings with researchers in order to make sense of data in a process of co-analysis. This study is reported using Standards for Reporting Qualitative Research reporting guidelines. Results:High-quality fundamental care for people with dementia and/or delirium in hospital and their families was associated with the special space of the hospital unit;an aptitude for people with dementia; a capacity to translate person-centred fundamentals of care from rhetoric to reality; and an appreciation for teamwork. Conclusion:This study clarified how teams working in hospital can practise high-quality fundamentals of care for older people with dementia and/or delirium. Delivery of high-quality fundamental care in this setting was dependent, not only on nurses, but the entire ward team working cohesively in a "weave of commitment."

Implementing Silent Disco Headphones in a Hospital Unit: A Qualitative Study of Feasibility, Acceptance, and Experience Among Patients and Staff

“…The particular needs of older patients with cognitive impairment are often poorly recognized by hospital staff. Collier et al. (2020) found much can be done in the hospital setting to meet patients’ fundamental needs if the team is supported to translate person-centred care from rhetoric to reality.…”

Full issue

“…A study of community health services revealed the importance of time with patients, as well as creative ways of investing time in relationships (Dadich et al, 2018). Person-centredness, teamwork and particular qualities of physical spaces were key to professionals' brilliant care for people with cognitive impairment (Collier et al, 2020). Collier et al (2019) connected brilliance in home-based palliative care with anticipatory action (proactively addressing individualized needs with families) and flexible adaptability (balancing building relationships with administrative requirements).…”

Positive Organisational Arts-Based Youth Scholarship: Redressing Discourse on Danger, Disquiet, and Distress during COVID-19

“…Since its advent, POS has been extended into healthcare (POSH) to intentionally consider, make sense of, and raise the profile of those instances within organisational life—be they large-scale or modest—that exceed the expectation of those who deliver, manage, administer, or receive healthcare, sensu lato [ 86 , 87 , 88 ]. This has also involved the use of the methodology, video reflexive ethnography (POSH-VRE)—detail on this methodology can be sourced elsewhere [ 89 , 90 , 91 , 92 , 93 ].…”