Improving the care of people with dementia in general hospitals: evaluation of a whole-system train-the-trainer model

Sampson, Elizabeth L; Vickerstaff, Victoria; Lietz, Stephanie; Orrell, Martin

doi:10.1017/s1041610216002222

Cited by 35 publications

(96 citation statements)

References 14 publications

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“…The intervention improved staff attitudes and facilitated change leading to a number of improvements in the quality of care of patients with dementia in hospital wards. System‐wide dementia training (train the trainer model): One before‐and‐after study evaluated this intervention . At follow‐up, the “sense of competence in dementia care” training showed a statistically significant improvement in the intervention group.…”

Section: Resultsmentioning

confidence: 99%

“…In particular, criteria such as blinding are challenging to achieve in the hospital setting and is often unfairly reflected in the poor methodological quality ratings. Authors have reported the difficulty of recruitment (particularly using proxy consent), and the difficulty of collecting follow‐up data due to patient mortality, carer withdrawal, and response rates . Delivering effective staff training is challenging in a busy hospital; therefore, it is necessary for each situation to be mindful of the practicalities, the efficacy and staff preferences when considering delivery methods.…”

Section: Discussionmentioning

confidence: 99%

“…System-wide dementia training (train the trainer model): One before-and-after study evaluated this intervention. 46 At follow-up, the "sense of competence in dementia care" training showed a statistically significant improvement in the intervention group.…”

Section: Royal College Of Nursing Development Programme: One Before-mentioning

confidence: 90%

“…Authors have reported the difficulty of recruitment (particularly using proxy consent), 54 and the difficulty of collecting follow-up data due to patient mortality, carer withdrawal, 54 and response rates. 25,46 Delivering effective staff training is challenging in a busy hospital; therefore, it is necessary for each situation to be mindful of the practicalities, the efficacy and staff preferences when considering delivery methods. It has also been suggested that effective sustainable interventions must involve communication and negotiation with people at all levels in the organisation.…”

Section: Implications For Research and Practicementioning

confidence: 99%

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The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

Feast

White

Candy

et al. 2020

Int J Geriat Psychiatry

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Background People with dementia are at greater risk of being admitted to hospital where care may not be tailored to their needs. Interventions improving care and management are vital. Aim Assess the effectiveness of interventions designed to improve the care and management of people with dementia in hospital. Method Six medical and trial registry, and grey literature databases were searched (1999‐1998/2018). Search terms included “Dementia,” “Hospital,” and “Intervention” and limited to experimental designs. Interventions designed to improve the care and management of people with dementia in the general hospital setting were examined. Outcomes included behavioural and psychological symptoms of dementia (BPSD), psychosocial, clinical, staff knowledge, and length of hospital stay. The CASP tools, Cochrane risk of bias tool, and GRADE system assessed methodological quality and certainty of evidence. Results 9003 unique citations were identified; 24 studies were included. Studies were limited in study design and their conduct was at a risk of bias. There is very low‐quality evidence that multisensory behaviour therapy reduces BPSD. There is low‐quality evidence that a multidisciplinary programme reduces postoperative complications and that robot‐assisted therapy, music therapy, multimodal‐comprehensive care, person‐centred care, and family‐centred function‐focused care interventions improved staff knowledge, competence, efficacy, and communication. No studies reported reduced length of stay. Conclusions Whilst we found that these interventions improved the care and management of people with dementia in hospital, it was low‐ to very low‐quality evidence. New clinical recommendations cannot be made based on current evidence, and robust trial designs are necessary to inform evidence‐based care.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Royal College Of Nursing Development Programme: One Before-mentioning

confidence: 90%

Section: Implications For Research and Practicementioning

confidence: 99%

See 2 more Smart Citations

The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

Feast

White

Candy

et al. 2020

Int J Geriat Psychiatry

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“…There is a call to pay more attention to peer learning and leadership support for making improvements in dementia care (Surr et al., ). Research is needed to understand “what works” and “how” to create success in knowledge translation and practice change (Sampson, Vickerstaff, Lietz, & Orrell, ).…”

Section: Introductionmentioning

confidence: 99%

The experience of hospital staff in applying the Gentle Persuasive Approaches to dementia care

Hung

Son

Hung

2018

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? Although the seminal work of McCormack et al. (International Practice Development Journal, 2015, 5, 1) and Nolan, Davies, Brown, Keady, and Nolan () provides useful conceptual frameworks in person‐centred care, research is needed to understand how theoretical concepts can be applied into practice to support dementia care. Also, evidence is needed to demonstrate the impacts of implementing person‐centred care and staff experiences. What does this paper add to existing knowledge? This paper adds to the emerging work that is providing a greater understanding of how team education in practice can make a difference in building capacity to improve dementia care. We offer timely evidence and useful insights into how an education programme, Gentle Persuasive Approaches (GPA), was implemented (“what worked” and “how”) in a large Canadian hospital to improve knowledge and skills among staff in dementia care. The GPA education helped hospital staff enact person‐centred care by cultivating shared values and a learning environment to change attitudes, practices and conditions for continuous practice development. What are the implications for practice? Mental health nurses in advance practice are well positioned to lead dementia education and advocate for person‐centred care in hospitals. Hospital leaders are responsible for providing resources to cultivate a supportive environment for continuous learning to ensure the workforce gains the capacity to meet the changing demands and needs of the ageing population. System support is essential for creating conditions to enable person‐centred care. Abstract IntroductionHospital staff lacks knowledge and skills in dementia care. There is a need to understand how person‐centred care theory can be operationalized in staff's practices to improve dementia care. AimsTo describe the staff's experiences of learning and applying the Gentle Persuasive Approaches (GPA) to enact person‐centred care in a hospital. MethodsMixed methods, including posteducation survey and focus groups, were used. Thematic analysis was conducted to identify themes that describe participants’ experiences. ResultsThree hundred and ten staff and leaders in a hospital participated in the GPA education and completed a posteducation survey (n = 297). After 1 year, two follow‐up focus groups were conducted with interdisciplinary staff (n = 24) across medicine and mental health programmes. Our analysis identified three themes to enable person‐centred care: (a) changing attitudes, (b) changing practices and (c) changing conditions. DiscussionThis study contributes to the literature by providing evidence of how an education programme was implemented in a large Canadian hospital to build capacity for dementia care. Joint education for interprofessional staff offers value in enabling person‐centred care. ImplicationMental health nurses are in position to lead dementia education and advocate for person‐centred care in hospitals. Staff need structural support to engage...

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Optimising care for patients with cognitive impairment and dementia following hip fracture

et al. 2017

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The global shift in demographics towards aging populations is leading to a commensurate increase in age-related disease and frailty. It is essential to optimise health services to meet current needs and prepare for anticipated future demands. This paper explores issues impacting on people living with cognitive impairment and/or dementia who experience a hip fracture and are cared for in acute settings. This is important given the high mortality and morbidity associated with this population. Given the current insufficiency of clear evidence on optimum rehabilitation of this patient group, this paper explored three key themes namely: recognition of cognitive impairment, response by way of training and education of staff to optimise care for this patient group and review of the importance of outcomes measures. Whilst there is currently insufficient evidence to draw conclusions about the optimal ways of caring for patients living with dementia following hip fracture, this paper concludes that future research should improve understanding of healthcare staff education to improve the outcomes for this important group of patients.

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Improving the care of people with dementia in general hospitals: evaluation of a whole-system train-the-trainer model

Cited by 35 publications

References 14 publications

The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

The effectiveness of interventions to improve the care and management of people with dementia in general hospitals: A systematic review

The experience of hospital staff in applying the Gentle Persuasive Approaches to dementia care

Optimising care for patients with cognitive impairment and dementia following hip fracture

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