P2‐071: “Dementia‐friendly hospitals: Care not crisis”—improving the care of the hospitalized patient with dementia

Background: People with dementia occupy up to one quarter of acute hospital beds. However, the quality of care delivered to this patient group is of national concern. Staff working in acute hospitals report lack of knowledge, skills and confidence in caring for people with dementia. There is limited evidence about the most effective approaches to supporting acute hospital staff to deliver more person-centred care.Objectives: This study aimed to evaluate the efficacy of a specialist training programme for acute hospital staff regarding improving attitudes, satisfaction and feelings of caring efficacy, in provision of care to people with dementia.Design: A repeated measures design, with measures completed immediately prior to commencing training (T1), after completion of Foundation level training (T2: 4-6 weeks post-baseline), and following Intermediate level training (T3: 3-4 months postbaseline). Setting: One NHS Trust in the North of England, UK.Participants: 40 acute hospital staff working in clinical roles, the majority of whom (90%) were nurses.Methods: All participants received the 3.5 day Person-centred Care Training for Acute Hospitals (PCTAH) programme, comprised of two levels, Foundation (1/2 day) and Intermediate (3 days), delivered over a 3-4 month period. Staff demographics and previous exposure to dementia training was collected via a questionnaire. Staff attitudes were measured using the Approaches to Dementia Questionnaire (ADQ), satisfaction in caring for people with dementia was captured using the Staff Experiences of Working with Demented Residents questionnaire (SEWDR) and perceived caring efficacy was measured using the Caring Efficacy Scale (CES). Results:The training programme was effective in producing a significant positive change on all three outcome measures following intermediate training compared to baseline. A significant positive effect was found on the ADS between baseline and after completion of Foundation level training, but not for either of the other measures. Conclusions:Training acute hospital staff in Intermediate level person-centred dementia care is effective in producing significant improvements in attitudes towards and satisfaction in caring for people with dementia and feelings of caring efficacy. Foundation level training is effective in changing attitudes but does not seem to be sufficient to bring about change in satisfaction or caring efficacy.2 Keywords: acute hospitals; dementia; education; general hospitals; person-centred care; staff training. Contribution of the paper:What is already known about this topic? Care for people with dementia is has often been found to be of poor quality in acute general hospitals and deficiencies in staff knowledge, skills and confidence to deliver dementia care is a contributory factor.  Person-centred dementia care can improve quality of life for people with dementia in specialist settings but there remains limited knowledge and understanding about its application in acute hospitals.  There is limited research about the...

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“…This supports findings from previous studies (Banks et al, 2014, Elvish et al, 2013, Galvin et al, 2012 which have demonstrated similar results.…”

Section: Discussionsupporting

confidence: 93%

“…Galvin et al (2012) implemented a 7-hour training programme across four community hospitals in the US. They evaluated impact via a pre-test, post-test and 120-day delayed post-test evaluation with 540 staff working in 4 community hospitals.…”

Section: Background To the Studymentioning

confidence: 99%

Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study

Surr¹,

Smith

Crossland³

et al. 2016

International Journal of Nursing Studies

120

185

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“…Similarly, Turner, Eccles, Elvish, Simpson & Keady (2015) recommended that dementia care training should be specifically tailored for hospital wards and should evaluate patient outcomes once completed; since most of the studies to date focus mainly on staff outcomes (Elvish et al, 2014, Galvin et al, 2010.…”

Section: Dementia Care Training and Educational Interventions In Clinmentioning

confidence: 99%

Using appreciative inquiry to implement person-centred dementia care in hospital wards

2016

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The quality of care of persons with dementia in hospitals is not optimal and can be challenging. Moreover, staff may find difficulty in translating what they have learned during training into practice. This paper report the development and evaluation of a set of workshops using an appreciative inquiry approach to implement person-centred dementia care in two hospital wards. Staff worked collaboratively to develop a ward vision and to implement a number of action plans. Using appreciative inquiry approach, staff attitudes towards persons with dementia improved, inter-professional collaboration was enhanced and small changes in staff practices were noted. Dementia care in hospitals can be enhanced by empowering staff to take small but concrete actions after they engage in appreciative inquiry workshops, during which they are listened to and appreciated for what they can contribute.

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“…In the hospital, staff often confront behavioral challenges, for which little formal training is provided. Common behavioral challenges include medication refusal, rejection of needed assistance, fearfulness of medical procedures, heightened confusion, agitation, and verbal/ physical aggression toward staff (Galvin et al, 2010).Managing behaviors is associated with low job satisfaction and burnout (Brodaty, Draper, & Low, 2003;Miyamoto, Tachimori, & Ito, 2010 Dementia, 2014;Sadowsky & Galvin, 2012). Although nonpharmacological approaches to managing behaviors are endorsed by medical organizations as frontline treatment, they are not typically used because of a lack of knowledge of their evidence, a lack of training in using nonpharmacological strategies, the perception that such strategies require more time, and a lack of supportive clinical environments for their use (Kolanowski, Fick, Frazer, & Penrod, 2010).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia

Marx¹,

Stanley²,

Haitsma³

et al. 2014

J Gerontol Nurs

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ARTICLEHOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE Instructions 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certifi cate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must:1. Read the article, "Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia" found on pages 26-34, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certifi cate will be automatically generated.This activity is valid for continuing education credit until November 30, 2016. Contact HoursThis activity is co-provided by Villanova University College of Nursing and SLACK Incorporated.Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Activity Objectives1. Discuss the learning needs of staff on a dementia care unit.2. Describe challenging behaviors that occur in patients with dementia. Disclosure StatementNeither the planners nor the authors have any confl icts of interest to disclose. of Gerontological Nursing, 40(12),[26][27][28][29][30][31][32][33][34] 26Copyright © SLACK Incorporated cne ARTICLE iors, physiological instability, and safety concerns result in increased risk of hospitalizations (Callahan et al., 2012;Toot, Devine, Akporobaro, & Orrell, 2013). In the hospital, staff often confront behavioral challenges, for which little formal training is provided. Common behavioral challenges include medication refusal, rejection of needed assistance, fearfulness of medical procedures, heightened confusion, agitation, and verbal/ physical aggression toward staff (Galvin et al., 2010).Managing behaviors is associated with low job satisfaction and burnout (Brodaty, Draper, & Low, 2003;Miyamoto, Tachimori, & Ito, 2010 Dementia, 2014;Sadowsky & Galvin, 2012). Although nonpharmacological approaches to managing behaviors are endorsed by medical organizations a...

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P2‐071: “Dementia‐friendly hospitals: Care not crisis”—improving the care of the hospitalized patient with dementia

Cited by 38 publications

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Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study

Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study

Using appreciative inquiry to implement person-centred dementia care in hospital wards

Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia

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