A person-centred approach is recognised as the best practice for people with dementia but can be difficult to apply in hospital settings. We want to find out how staff focusing on the safety of people with dementia can be supported to use person-centred care.
Summary
Constant observation is the practice of supporting patients during their hospital stay through additional monitoring, such as using one-to-one support (also known as specialling) or bay nursing (also known as cohorting). People with dementia with risks to themselves, such as from falls or leaving the ward, often receive this kind of support during a hospital admission.
Constant observation is a common practice across hospitals but who is responsible for this activity, how it is organised and what it achieves differs across hospitals and hospital wards. We are seeking to understand if, by focusing on a priority area of care for hospitals and hospital staff (patient safety), it is possible to embed a person-centred approach to care for people with dementia admitted to the hospital.
Project aims
The aim of the project was to co-design and evaluate the feasibility and acceptability of an intervention that promotes person-centred care for people with dementia during constant observation activities in hospitals.
The study objectives were:
1) To understand the resources and knowledge staff need to provide person-centred care during constant observation of people with dementia
2) To understand the use constant observation of people with dementia in three hospitals
3) To use a co-design an intervention that will support person-centred care during constant observation
4) To test the use of intervention with staff, people with dementia and family carers
Project Activity
We:
Conducted a systematic review.
Mapped the use of constant observation in three hospitals.
Co-designed the intervention with hospital staff, people with dementia and family members.
Tested the intervention in the three hospitals.
Refined the intervention through a consensus event.
Project Activities carried out
The intervention has been tested in 6 wards (at 3 hospitals) to see if staff found it useful, could it be used in everyday practice, does it make a difference. Also generating ideas about how intervention resources could be improved. Aims to identify impact on policy and discuss next steps for the study. Currently planning how the study will feedback to study sites and co-designers.
Impact
Evidence will establish if focusing on a priority area of care for hospitals and staff can embed person-centred care practices. Findings will be shared to inform care planning and delivery.
Papers and resources associated with this study
The systematic review is registered on PROSPERO: CRD42020221078
Disclaimer
This work was supported by funding from the Alzheimer’s Society (grant number 516).
Research and Institutions
Dr Melanie Handley, Professor Frances Bunn, Professor Claire Goodman (University of Hertfordshire)
Professor Claire Surr (Leeds Beckett University)
Professor Rowan Harwood (University of Nottingham)
Contacts
Dr Melanie Handley, m.j.handley@herts.ac.uk
