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Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care

Published online by Cambridge University Press:  23 November 2016

Joanne Tropea*
Affiliation:
Melbourne EpiCentre, Melbourne Health and University of Melbourne, Grattan Street, Parkville, Victoria, 3050, Australia
Dina LoGiudice
Affiliation:
Department of Aged Care, The Royal Melbourne Hospital, Royal Park Campus, 34 Poplar Rd, Parkville, Victoria, 3052, Australia
Danny Liew
Affiliation:
Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia
Carol Roberts
Affiliation:
Melbourne EpiCentre, Melbourne Health, Grattan Street, Parkville, Victoria, 3050, Australia
Caroline Brand
Affiliation:
Melbourne EpiCentre, Melbourne Health and University of Melbourne, Grattan Street, Parkville, Victoria, 3050, Australia Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, 3004, Australia
*
Correspondence should be addressed to: Joanne Tropea, Melbourne EpiCentre, Melbourne Health and University of Melbourne, Grattan Street, Parkville Victoria 3050, Australia. Phone: +61 3 9342 8772; Fax: +61 3 9342 8780. Email: Joanne.Tropea@mh.org.au.

Abstract

Background:

Best practice dementia care is not always provided in the hospital setting. Knowledge, attitudes and motivation, practitioner behavior, and external factors can influence uptake of best practice and quality care. The aim of this study was to determine hospital staff perceived barriers and enablers to implementing best practice dementia care.

Methods:

A 17-item survey was administered at two Australian hospitals between July and September 2014. Multidisciplinary staff working in the emergency departments and general medical wards were invited to participate in the survey. The survey collected data about the respondents’ current role, work area, and years of experience, their perceived level of confidence and knowledge in dementia care and common symptoms of dementia, barriers and enablers to implementing best practice dementia care, job satisfaction in caring for people with dementia, and to rate the hospital's capacity and available resources to support best practice dementia care.

Results:

A total of 112 survey responses were received. The environment, inadequate staffing levels and workload, time, and staff knowledge and skills were identified as barriers to implementing best practice dementia care. Most respondents rated their knowledge of dementia care and common symptoms of dementia, and confidence in recognizing whether a person has dementia, as moderate or high dementia. Approximately, half the respondents rated access to training and equipment as low or very low.

Conclusion:

The survey findings highlighted hospital staff perceived barriers to implementing best practice dementia care that can be used to inform locally tailored improvement interventions.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Alzheimer's Australia (2016). Key Facts and Statistics 2016. Available at: https://fightdementia.org.au/about-dementia/statistics; last accessed 1 June 2016.Google Scholar
Australian Institute of Health and Welfare (2013). Dementia Care in Hospitals: Costs and Strategies. Cat. no. AGE 72. Canberra: AIHW.Google Scholar
Bail, K. et al. (2013). Potentially preventable complications of urinary tract infections, pressure areas, pneumonia, and delirium in hospitalised dementia patients: retrospective cohort study. BMJ Open, 3 e002770. doi: 10.1136/bmjopen-2013-002770.Google Scholar
Ballarat Health Service (2016). Dementia Care in Hospitals Program. Available at: https://www.bhs.org.au/node/130; last accessed 18 July 2016.Google Scholar
Borbasi, S., Jones, J., Lockwood, C. and Emden, C. (2006). Health professionals' perspectives of providing care to people with dementia in the acute setting: toward better practice. Geriatric Nursing, 27, 300308.CrossRefGoogle ScholarPubMed
Cabana, M. D. et al. (1999). Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA, 282, 14581465.Google Scholar
Canadian Institutes of Health Research (CIHR) (2014). KT Clearinghouse: The Knowledge-to-Action-Cycle. Available at: http://ktclearinghouse.ca/knowledgebase/knowledgetoaction; last accessed 6 July 2016.Google Scholar
Dementia Enabling Environments (2016) Dementia enabling environments principles. Available at: http://www.enablingenvironments.com.au/dementia-enabling-environment-principles.html; last accessed 18 July 2016.Google Scholar
Fessey, V. (2007). Patients who present with dementia: exploring the knowledge of hospital nurses. Nursing Older People, 19, 2933.Google Scholar
Galvin, J. E., Kuntemeier, B., Al-Hammadi, N., Germino, J., Murphy-White, M. and McGillick, J. (2010). “Dementia-friendly hospitals: care not crisis”: an educational program designed to improve the care of the hospitalized patient with dementia. Alzheimer Disease & Associated Disorders, 24, 372379.Google Scholar
Rotter, T. et al. (2010). Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database of Systematic Reviews, CD006632. doi: 10.1002/14651858.CD006632.pub2.Google Scholar
Sampson, E. L., Gould, V., Lee, D. and Blanchard, M. R. (2006). Differences in care received by patients with and without dementia who died during acute hospital admission: a retrospective case note study. Age Ageing, 35, 187189.Google Scholar
Spector, A., Revolta, C. and Orrell, M. (2016). The impact of staff training on staff outcomes in dementia care: a systematic review. International Journal of Geriatric Psychiatry, doi:10.1002/gps.4488. [Epub ahead of print].Google Scholar
Straus, S. E. and Holroyd-Leduc, J. (2008). Knowledge-to-action cycle. Evidence Based Medicine, 13, 98100.Google Scholar
Tropea, J., LoGiudice, D., Liew, D., Gorelik, A. and Brand, C. (2016). Poorer outcomes and greater healthcare costs for hospitalised older people with dementia and delirium: a retrospective cohort study. International Journal of Geriatric Psychiatry, doi: 10.1002/gps.4491. [Epub ahead of print].Google Scholar
Wenger, N. S. et al. (2007). Application of assessing care of vulnerable elders-3 quality indicators to patients with advanced dementia and poor prognosis. Journal of American Geriatrics Society, 55, S457S463.Google Scholar
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