Background The following questionnaire has been developed to assess how well staff feel they are supported to provide good quality care/support to people with dementia. If your job role means you never interact with any patients in the hospital then you have received this questionnaire in error and you do not need to complete it. When answering the questions you should think specifically about people you care for/ support who have dementia or possible dementia. Each question has a range of responses. Please select the response which best describes how you feel. Some questions will not be applicable to all hospital staff - if a question is not applicable to your role, please select the 't applicable in my role' option. There are 16 questions in the questionnaire followed by some demographic and evaluation questions. It should not take more than 20 minutes to complete. Questions are mandatory unless marked as (optional) and you will not be able to submit until you have answered all the mandatory questions. The evaluation questions are optional. Please use the comment boxes to make any comments on the questions or expand on your answers. Questions should be answered based on your own experience and opinion. The questionnaire is anonymous, responses are sent directly to the National Audit of Dementia Project Team and reporting will not identify you in any way. Find out more information please visit www.nationalauditofdementia.org.uk. If you need help completing the questionnaire, please contact the NAD project team on 020 3701 2697 or 020 3701 2688. HQIP 2015 STAFF QUESTIONNAIRE (Community Hospital Feasibility Study) Third round of audit (2015) Enter your hospital code: This is the code you will have been sent in the information sheet attached to an email from the audit lead contact. It will consist of 2 letters and 2 numbers, e.g. XY11. If you do not know the hospital code, please get in touch with the audit lead from your hospital or contact the NAD project team on 020 3701 2697 / 2688. HQIP 2015 Page 1 of 11
1. Please select your job title: Doctor (Consultant) Doctor (GP) Doctor (Junior) Doctor (Staff Grade) Healthcare Support Worker/Assistant Nurse - Band 5 or 6 Porter Student Allied Healthcare Professional Ward Clerk/Administrator Other If other, please specify: 2. Are you based at this hospital? Yes 3. Please enter your directorate (if known): (optional) 4. Approximately, what percentage of the patients you encounter in your role have dementia or possible dementia? Please indicate on the scale below Housekeeper- Catering/Cleaning Nurse - Band 7 or above Qualified Allied Healthcare Professional (e.g. physiotherapist, Occupational therapist) Student Nurse Ward Manager 0 10 20 30 40 50 60 70 80 90 100 HQIP 2015 Page 2 of 11
1. If you are providing care/ support for someone with dementia, do you feel supported by specialist services for dementia in your hospital? E.g. dementia specialist team, mental health liaison, dementia champions Mon-Fri (9am-5pm) Out of Hours t applicable in my role 2. What form did your dementia training at this hospital take? Please tick all that apply E-Learning Workshop Study Day Higher Education Module Other I have not received any dementia training at this hospital(go to Q4) t applicable in my role (Go to Q4) If other, please specify: HQIP 2015 Page 3 of 11
3. Following your training at this hospital, do you feel better prepared to provide care/ support to people with dementia? Yes, much better prepared Yes, somewhat better prepared 4. Within your hospital, is personal information available to you to help you provide care/ support to people with dementia? E.g. their likes/ dislikes, preferred name, past job (Go to Q5) t applicable in my role (Go to Q5) 4a. Do you have the opportunity to use this information to help you provide care/ support? t applicable in my role HQIP 2015 Page 4 of 11
5. In your current role, do you feel encouraged to accommodate the individual needs and preferences of people with dementia? E.g. taking time to speak and interact at the pace of the person with dementia, permitting them to walk around the ward t applicable in my role 6. As a team, how often do you talk about the way you provide care/ support to people with complex needs (including dementia)? Never Almost Never Occassionally Frequently t applicable in my role 7. Is your ward/ service able to respond to the needs of people with dementia as they arise? E.g. pain relief, personal care, toileting, mobility assistance t applicable in my role HQIP 2015 Page 5 of 11
8. Is additional staffing support provided if dependency needs on the ward increase? t applicable in my role 9. Are night time bed moves for people with dementia avoided where possible? By night time bed moves, we mean moves between the evening meal and breakfast the next morning t applicable in my role 10. Can carers of people with dementia visit them at any time? t applicable in my role HQIP 2015 Page 6 of 11
11. In the last week (except in emergency situations), were patient mealtimes kept free of any clinical activity? t applicable in my role 12. Can you access finger foods (food which can be eaten without a knife/ fork/ spoon) for people with dementia as an alternative to main meals? t applicable in my role 13. Can you access snacks for people with dementia between meals... t applicable in my role...during the day?...at night time? HQIP 2015 Page 7 of 11
14. Are nutrition and hydration needs of people with dementia communicated at handovers/ safety briefings? Nutrition Hydration t applicable in my role 15. Do you think the people with dementia you care for/ support, have their nutritional needs met while in the hospital? t applicable in my role 16. Please give one example of how your hospital could improve care for people with dementia: (Optional - max 50 words please) HQIP 2015 Page 8 of 11
Background/demographic information Please complete the questions below so that we can compare the experiences of different staff groups. 1. How do you define your gender? Male Female Other Prefer not to say 2. Please specify your ethnicity: White Black/Black British Asian/Asian British Mixed Chinese Other Prefer not to say 3. Approximately, how many hours a week do you work in this role? Up to 29 hours 30 hours or more 4. Approximately, how long have you worked in this hospital? Less than 6 months 6-11 months 1-2 years 3-5 years 6-10 years 11-15 years More than 15 years HQIP 2015 Page 9 of 11
Questionnaire Evaluation (Optional) Please complete the following questions to help us understand how you found completing the questionnaire so that we can improve it for use in the National Audit of Dementia next year 1. This questionnaire will provide an accurate picture of the support staff receive to provide good quality care to people with dementia: Strongly Agree Agree Disagree (Go to Q1a) Strongly Disagree (Go to Q1a) 1a. If you disagree/strongly disagree, why? 2. Were all the questions easy to answer? Yes (Go to Q2a) 2a. Which questions were hard to answer and why? 3. Which questions in this questionnaire do you think are most relevant to providing good quality care to people with dementia? HQIP 2015 Page 10 of 11
4. Which questions in this questionnaire do you think are least relevant to providing good quality care to people with dementia? 5. Are there additional questions you would have liked to have seen included? If yes, please specify: General comments on the questionnaire: This is the end of this questionnaire. You must press the submit button at the bottom of this page or in the left hand navigation panel otherwise we will not receive your responses. Please note once you submit this form, you will not be able to re-access it so please ensure all questions are correct before pressing submit. Thank you for completing this questionnaire. HQIP 2015 Page 11 of 11