Nicola Haak, Ward Sister, Royal Surrey County Hospital NHS Trust (RSCH)

Background

I work on an Orthopaedic Trauma ward with a proportion of patients with dementia. Concerns were raised when senior staff observed delivery of care that disregarded the person involved as they were focusing on achieving a task rather than the needs, desires or wants of the patients. Lack of understanding and ability to communicate with the patients with dementia was causing distress to the patients and their families.

Aim

• Enhance privacy and dignity for patients with dementia.
• Raising awareness and providing opportunities to develop knowledge and skills in dementia care.
• Promote a culture of person-led care and abolish task oriented care delivery.
• Feed back questionnaires obtained from staff, patients and relatives.

What did you do?

• Funding was raised by an annual 'Forget Me Not' Ball. The FoNS Centre for Nursing Innovation (FoNS) also provided funds for the project.
• Workshops for the multidisciplinary team in dementia care were facilitated by a Clinical Specialist in Dementia care (Jan Dewing).
• The development of a designated bay allocated for trauma patients with dementia called 'The Forget Me Not Bay'.
• The creation of a working group of 'Forget Me Not Champions' to facilitate the exchange of ideas and implementations of actions to improve the hospital experience for this group of patients.

The ward nurses became very involved with the project and after initial doubts the 'Forget Me Not Bay' is now a favoured place to work on the ward. The atmosphere and vibe is totally different to the rest of the ward.

The culture of care delivery has changed dramatically. The initial devolpment was done by myself and on reflection I should have involved the Hospital Management and Practice development team more.

What changed?

Patients with dementia on the Orthopaedic Ward now have a raised profile and awareness of their specific needs.

Care plans are developed to meet their individual needs. All have an 'All about Me' leaflet which is filled in by carers and relatives to help give a better understanding of the lives and interests of patients. This helps communication and interaction between staff and patients.

The designated bay provides an environment that is calm, relaxing and cosy. Old time music is played, a fridge for snacks, art work is displayed and a wall mural has been painted by a local art student. Signage has been improved for the toilet. Games and puzzles are available. A table is used for meal times to help improve social interaction and nutritional intake.

I am surprised at how popular the 'Forget Me Not' bay is but I am very pleased.  I think funding is a problem as training needs to be an ongoing project as staff members change. Feedback from visiting nurses, students and relatives is very positive.

Advice for others

This is sustainable because the underlying culture of the ward has changed. I believe it could be taken up by others but would need someone with passion and motivation. Funding for training is a major issue as we rely on charity which requires personal effort and time. There has been no formal analysis of the costs and benefits.

For further information please contact Nicola Haak at nikkijhaak@btinternet.com

See other examples at Dementia - best practice examples.