DEVELOPMENT OF PRACTICE IN NON ACUTE HOSPITALS

Transcription

1 DEVELOPMENT OF PRACTICE IN NON ACUTE HOSPITALS NURSE MANAGER WARD SISTERS AND MULTI DISCIPLINARY LEADS FORMULATED A LONG TERM PLAN FOR THE DEVELOPMENT OF NURSING AND MULTIDISCIPLINARY PROFESSIONAL PRACTICE IN NON ACUTE HOSPITALS BASED ON LEARNING FROM INCIDENTS, COMPLAINTS, NQI AUDIT FEEDBACK AND SUGGESTIONS FROM NURSING STAFF ON THEIR TRAINING AND DEVELOPMENTAL NEEDS VIA THEIR KSF WORKSTREAMS INCLUDED Promotion of Rehabilitation techniques Stroke competencies Management of patients suffering memory loss and confusion Promotion of Continence and management of incontinence Falls Pressure Ulcer management Communication Record keeping Releasing time to care 1

2 MANAGEMENT OF PATIENTS WITH MEMORY LOSS Research has revealed that older people with Memory impairment, Dementia, Alzheimer's or acute Delirium remain in hospital longer than those without. SNOW BALL EFFECT Alzheimer s Society is calling for hospitals to reduce the time a person with dementia spends in hospital by just one week. This could reduce an untold amount of stress on the person suffering from dementia and has a potential saving of 80 million per year 2

3 MANAGEMENT OF PATIENTS WITH MEMORY LOSS Snapshot Baseline completed in all wards showed 33% of our patients had memory problems 3

4 WORK STREAMS DEVELOPED FOR THE MANAGEMENT OF PATIENTS WITH MEMORY LOSS AND CONFUSION 4 Work streams Environment Nutrition Guidelines for staff in Risk assessing patients in respect of the requirement for supervision Delirium Butterfly This is me Distraction Therapies Staff Training /Dementia Champions John s campaign Baton Scheme

5 ENVIRONMENT Environmental audit of 5 wards in Non Acute Hospitals (NAH) was completed with the support of the OT in the memory team Paintwork Signage Noise from equipment i.e. Bins Lighting Clocks/Day/Date/Season/Time/Place Crockery Red Trays 5

6 WHY WE NEED DEMENTIA- FRIENDLY ENVIRONMENTS The person may have difficulty managing their emotional response to their experience Fear Distress Anger Panic Suspicion Denial 6

7 ORIENTATION CAN BE PROVIDED BY Accent colours Identification of bays, Signage on bathrooms, toilets, beds Pictures of local areas Artwork Personal and self care items Photographs and memory boxes Traditional crockery and cutlery Calendars Large face clocks Natural light Signs denoting ward and hospital name Views of nature Visible staff

8 8 ACCENT COLOURS PAINTWORK

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10 10 STAFF AREAS

11 CONTRASTING WALLS & FLOORS DIFFERENT COLOURS TO DIFFERENCIATE 11

12 12 SIGNAGE IN BATHROOMS

13 Environmental Distraction Aids 13

14 PICTURE WINDOW

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16 WHAT IS THE BUTTERFLY SCHEME The Butterfly Scheme was created by a carer and is taught by family carers and helps us to see hospital care though their eyes. The Butterfly Scheme provides a system that demands a specific care response for people living with dementia or who simply find that their memory isn t as reliable as it used to be. 16

17 BUTTERFLY Use of Butterfly Symbol REACH principles

18 Implementation of Butterfly scheme in Non Acute Hospitals Study day on the Butterfly Scheme. Following this we made an application to join the scheme and won the funding Sept 2013 Launch of the Butterfly Scheme, initially training 100 staff from all disciplines. First hospital in N. Ireland to launch the scheme Produced training Packs for wards and departments Rollout training 18

19 BARRIERS TO IMPLEMENTATION OF THE BUTTERFLY SCHEME IN NAH Barriers Required guidance on how to offer the scheme Retraining of staff and training of new staff Ownership 19

20 PROGRESS WITH IMPLEMENTATION OF THE BUTTERFLY SCHEME IN NAH 3 monthly multi disciplinary dementia champion meetings. Feedback from relatives/carers Provided updated training for staff 20

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22 22 DISTRACTION THERAPIES

23 DOLL THERAPY Sally 85, On admission was labelled as aggressive due to her behaviour which involved her hitting out at staff and spitting. Introduced Doll therapy The doll was head to toe in pink. Sally called him Jack and Sally adored Jack. Family expressed that the change in Sally was phenomenal. Sally became less anxious and did not display any further behavioural issues 23

24 DOLL THERAPY CASE STUDIES Billy 86 dementia, farmer Biddy, loved minding her nieces and nephews 24

25 Word Searches Picture windows 25

26 26 STAFF MASCOT

27 27 STAFF / RELATIVE FEEDBACK

28 28 Thank you