6 month interim review of service qualitative repeat observational audit & satisfaction surveys:...
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6 Month interim review of service
Qualitative
Repeat observational audit & satisfaction surveys:
The approach to patients by staff has improved with a better understanding of communication needs and role modelling of the Dementia Buddies
The eating and drinking needs of the patients have improved with the Dementia Buddies providing assistance at lunchtime and encouraging the patients to drink throughout the morning
Maintenance of cognitive ability and reducing agitation and behavioural challenges, and freeing up the time of the ward staff, are helped by the activities provided by the buddies such as: Reading Discussing picture books Dancing Singing Board games Simply conversing and companionship
More effective signposting of patients and carers to support both outside of the hospital environment once the person with dementia is discharged is taking place
What the Buddies did during their visitActivity Number
Reminiscence 12
Talking/chatting 120
Walking 1
Reading 13
Eat/Drink 10
Music 6
Encouraged Nutrition 24
Other 8
Daily Records Evaluation
Alert Lively Hungry Neat & Tidy
Happy Chatty Thirsty Untidy
Sad Quiet Agitated Confused
Calm Withdrawn Frustrated Depressed
Content Bored Angry Tired
Daily Records- between Oct.2012 and March 2013. (N=155)
On Arrival On Leaving Difference in Totals
Total TotalWords circled 374 348 (26)Total score + 36 +197 +161Average score +0.1 +0.6 +0.5
What Patients have said:
“patient said kind of me to visit and hopes to see me again”
“Patient thanked me for my help”
“Pleased to see me and responded well, talked well, liked her hand held.”
Patient responses recorded by Buddies
Patient pleased to remember us. Enjoyed chatting. Is a quiet lady but enjoys a laugh. Was thirsty and enjoyed 2 cups of squash.
Patient enjoys holding hands and listening to stories. She likes hugs and cuddles and kisses and often asks for company. She won't chat back but she will tell you not to go away in the end.
Patient was tired eyes closed but happy for me to sit with
her holding her hands. Happy someone there for her.
Carers/Relatives Evaluation
As well as expected
Better than expected
Worse than expected
0
1
2
3
4
5
6
7
8
9
10
10
5
0
How was your relative/friend today?
Care
rs
Quotes from Carers/Relatives
“When I am not here my mother gets quite tearful and lonely so I think the scheme is a good idea.”
“Somebody came a few days ago and talked to mum about Gravesend of many years ago (not today). She really enjoyed this.”
“No matter how little, having company can be sensed and will be a comfort.”
“Excellent service and much needed”
Staff Evaluation N=9
Question Yes No
Ward atmosphere enhanced
6 0
Improved Understanding
7 0
Difference made to your role
5 1“ my job is administrative...”
Difference made to patients
5 1“ my job is administrative...”
Quotes from Ward Staff
“ Patients get more settled, less agitated and more lively and are more alert and can follow through the routines affectively.” Staff Nurse
“ They all help us as a health care assistant may help us. They keep them orientated.” HCA
“ They settle down when they are agitated. Eat/drink well because of dementia buddy” Staff Nurse
“ The ward has a very good understanding of dementia but the buddies have enhanced this.” Senior staff Nurse
Quantitative evaluation Too early to see impact as buddies not fully
established However: Overall LOS on Ebony reduced by 2 days Average LOS for patients with a diagnosis
of dementia reduced from 30.0 to 20.8 days (30% reduction)
Complaints baseline was minimal so not meaningful to measure
Dementia Buddy specific readmissions hard to audit
Falls
The Future
Final Pilot evaluation in June and share results and experience with other Trusts
Business Case for Trust to continue role:
53 hours (1.42 WTE band 5 co-ordinator posts) 0.5 WTE Admin support Band
2 £10,000 for training
Expand service hours to 6 hours per day, 7 days per week
Continue to roll scheme out to other wards/Depts within the hospital
Emergency Dept
Provide an ‘on request’ service for individual cases
Continue with partnership working between the hospital and ADSS
Integration Awards
Nursing Standard
Jeremy Hunt
Other initiatives at DVHProgress Education CQUIN trigger part of
EDN Dementia & MCA
pathways developed and agreed
Cognitive impairment Care plan implemented
Reduction in LOS Care Homes Project MSS & Dr Yu Extended Therapy
Service to cover weekends
Acute physician
Evergreen/Geriatrician of the Week
Elderly Care Specialist Nurse (Feb-12)
Dignity Champions Nursing Care
complaints reduced Productive Older
Peoples Project/Patient Experience Programmes
National Dementia Audit 2nd Round
Observational Audit Programme
PAT Dog
Future Plans
Dementia Challenge funding:
Dementia Specialist Practitioner
Environmental changes: Signage Pilot Colour Scheme in bays
(Ebony) Pictures relating to colours Bed spreads Curtains Toilet Seats
Charitable Funds:
Picture books/memory boxes
Reminiscence corridor
MP3
Sensory Garden
Laundry
Expansion of Dementia Buddy Scheme
Thank youAny Questions?