Improving staff’s ability to work with challenging patient behaviours: An acute care approach

Asomaning, Nana; Ramsden, Rebecca; Salvi, Kera; Chetram, Vishaka Keshav

doi:10.5430/jnep.v6n2p139

Cited by 1 publication

(15 citation statements)

References 7 publications

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“…Twenty-two of the papers reported effectiveness of interventions to improve experience of care, 134,139-141,163,165-181 two papers reported both effectiveness and cost-effectiveness analyses 150,182 and two additional papers reported only cost-effectiveness 164 or a comparative cost analysis. 183 In terms of study design, the 25 studies included three RCTs, 163,173,176 one cluster RCT, 171 four controlled before-and-after studies, 139-141, 150 13 uncontrolled before-and-after studies, 134, [165][166][167][168][169][170]172,174,175,178,181,183 two time series studies 177,179 and two prospective cohort studies. 180,182 All included studies were journal articles and published between 1994 and 2018.…”

Section: Study and Sample Characteristicsmentioning

confidence: 99%

“…Two studies 139,140 used a waitlist control group and the remaining studies included active comparators such as standardised activity sessions (instead of tailored activities 177 ), unstructured social activity (without involving art activity 180 ) and standard educational support providing advice following staff request. 140 Eleven studies 134, [165][166][167][168][169][170]172,174,175,181 used pre-intervention estimates as the comparator.…”

Section: Characteristics Of Studies Assessing Effectiveness Of Intervmentioning

confidence: 99%

“…Five studies 163,[171][172][173]181 reported on the impact of interventions on carer outcomes, including satisfaction with care, communication with providers and carer well-being. Fifteen studies 134,[139][140][141][165][166][167][168][169][170][171][172][173]177,178 reported outcomes for hospital staff across a range of categories, including self-efficacy and confidence in providing care, attitudes towards people living with dementia, satisfaction in caring, communication between staff, and other outcomes linked to staff well-being. Study duration varied, but studies were generally short and ranged from 9 days to 24 months.…”

Section: Characteristics Of Studies Assessing Effectiveness Of Intervmentioning

confidence: 99%

“…One 139 of the studies focused on training nursing students. Four studies 141,[165][166][167] reported that the educational materials or curriculum had been developed after existing frameworks had been adapted or following focus group discussions about staff learning needs. Two studies 168,169 incorporated a train-the-trainer component whereby nominated individuals were trained and then tasked to deliver the training to other hospital staff.…”

Section: Intervention Categories and Componentsmentioning

confidence: 99%

“…Two studies 168,169 incorporated a train-the-trainer component whereby nominated individuals were trained and then tasked to deliver the training to other hospital staff. Six studies [139][140][141]165,167,168 reported staff (or students) being supported to cement new knowledge and practice after training through reflective discussions and availability of mentors, direct feedback while working on the ward or institutional-level commitment to the training and improvement of care of people living with dementia. Five studies specified the approach guiding the training, including PCC, 167,169 gentle persuasive approaches 140,165 and the VERA framework.…”

Section: Intervention Categories and Componentsmentioning

confidence: 99%

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Understanding and improving experiences of care in hospital for people living with dementia, their carers and staff: three systematic reviews

Gwernan‐Jones

Lourida

Abbott

et al. 2020

Health Serv Deliv Res

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Background Being in hospital can be particularly confusing and challenging not only for people living with dementia, but also for their carers and the staff who care for them. Improving the experience of care for people living with dementia in hospital has been recognised as a priority. Objectives To understand the experience of care in hospital for people living with dementia, their carers and the staff who care for them and to assess what we know about improving the experience of care. Review methods We undertook three systematic reviews: (1) the experience of care in hospital, (2) the experience of interventions to improve care in hospital and (3) the effectiveness and cost-effectiveness of interventions to improve the experience of care. Reviews 1 and 2 sought primary qualitative studies and were analysed using meta-ethnography. Review 3 sought comparative studies and economic evaluations of interventions to improve experience of care. An interweaving approach to overarching synthesis was used to integrate the findings across the reviews. Data sources Sixteen electronic databases were searched. Forwards and backwards citation chasing, author contact and grey literature searches were undertaken. Screening of title and abstracts and full texts was performed by two reviewers independently. A quality appraisal of all included studies was undertaken. Results Sixty-three studies (reported in 82 papers) were included in review 1, 14 studies (reported in 16 papers) were included in review 2, and 25 studies (reported in 26 papers) were included in review 3. A synthesis of review 1 studies found that when staff were delivering more person-centred care, people living with dementia, carers and staff all experienced this as better care. The line of argument, which represents the conceptual findings as a whole, was that ‘a change of hospital culture is needed before person-centred care can become routine’. From reviews 2 and 3, there was some evidence of improvements in experience of care from activities, staff training, added capacity and inclusion of carers. In consultation with internal and external stakeholders, the findings from the three reviews and overarching synthesis were developed into 12 DEMENTIA CARE pointers for service change: key institutional and environmental practices and processes that could help improve experience of care for people living with dementia in hospital. Limitations Few of the studies explored experience from the perspectives of people living with dementia. The measurement of experience of care across the studies was not consistent. Methodological variability and the small number of intervention studies limited the ability to draw conclusions on effectiveness. Conclusions The evidence suggests that, to improve the experience of care in hospital for people living with dementia, a transformation of organisational and ward cultures is needed that supports person-centred care and values the status of dementia care. Changes need to cut across hierarchies and training systems to facilitate working patterns and interactions that enable both physical and emotional care of people living with dementia in hospital. Future research needs to identify how such changes can be implemented, and how they can be maintained in the long term. To do this, well-designed controlled studies with improved reporting of methods and intervention details to elevate the quality of available evidence and facilitate comparisons across different interventions are required. Study registration This study is registered as PROSPERO CRD42018086013. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 43. See the NIHR Journals Library website for further project information. Additional funding was provided by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.

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Section: Study and Sample Characteristicsmentioning

confidence: 99%

Section: Characteristics Of Studies Assessing Effectiveness Of Intervmentioning

confidence: 99%

Section: Characteristics Of Studies Assessing Effectiveness Of Intervmentioning

confidence: 99%

Section: Intervention Categories and Componentsmentioning

confidence: 99%

Section: Intervention Categories and Componentsmentioning

confidence: 99%

See 3 more Smart Citations

Understanding and improving experiences of care in hospital for people living with dementia, their carers and staff: three systematic reviews

Gwernan‐Jones

Lourida

Abbott

et al. 2020

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

Improving staff’s ability to work with challenging patient behaviours: An acute care approach

Cited by 1 publication

References 7 publications

Understanding and improving experiences of care in hospital for people living with dementia, their carers and staff: three systematic reviews

Understanding and improving experiences of care in hospital for people living with dementia, their carers and staff: three systematic reviews

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