The Challenge

A recent Audit in the Division of Medicine, at this hospital showed that 49.6% of all inpatients showed signs of cognitive impairment, predominantly dementia and delirium.

There was a need to bring activity and cognitive stimulation into these acute environments to ensure that the patients with cognitive impairment have the best experience as inpatients at Imperial.

The Solution

The Units have been used extensively in the Medicine for the Elderly Wards with success. One of the Wards at St Mary’s is a 28 Bedded unit that is a step down unit for people following surgery, often orthopaedic surgery. The patients tend to have dementia and complex needs.

Initially on the ward, it was a real problem trying to provide the care that these patients with dementia required. If following surgery, the patients that have cognitive issues, can, quite often, develop post op delirium on top of their dementia and that means that providing care for them is quite challenging, especially in the environment they are in.

The technology has made such a difference, it has transformed the way we deliver our nursing care to patients with dementia. We recently won a Quality Improvement Award.

The Solution

There was no stimulation, they are in a very strange environment, unfamiliar, with no familiar faces, it is a very scary place for them, they have a lot of anxiety, a lot of frustration and a lot of aggression and sometimes they just do not know how to deal with the situation they find themselves in.

We have been able to work on the sleep/awake cycle so that they are not sleeping during the day and awake during the night. Stimulation is so important in the daytime, so that they are able to sleep at night. Having patients getting out of bed at night, when lighting is low and often less staffing poses a very high risk of falls. The technology has significantly helped with this level of stimulation.

Albert Ward and multi-disciplinary team

Introduction of My Improvement Network Technology

Falls Data Statistics

Albert Ward 24 Patient Capacity % Comments
Jul 2015 5 Falls 20.8
Aug 2015 8 Falls 33.3
Sept 2015 4 Falls 16.6
Oct 2015 8 Falls 33.3
Nov 2015 5 Falls 17.8 Technology Introduced
Dec 2015 1 Falls 0.35
Jan 2016 5 Falls 17.8
Feb 2016 2 Falls 0.71
Mar 2016 1 Falls 0.35
Apr 2016 10 Falls 35.7 Technology not available for 3 weeks
May 2016 14 Falls 50.0 Technology not available
Jun 2016 4 Falls 14.0 Technology re-introduced
Jul 2016 3 Falls 10.7
Aug 2016 4 Falls 14.0

The Solution

The technology provides opportunities for social interaction and reducing the feeling of isolation. Improving cognition – recent studies have shown that exercise may improve memory and slow down mental decline.

At St Mary’s we appreciate the importance of engaging with our patients and promoting exercise to bring many benefits for people with dementia, helping to improve the health of the heart and blood vessels can reduce the risk off high blood pressure and heart disease and also help to reduce the risk of falls.

On Albert Ward we trialled its first exercise group with great success!

We are getting people back on their feet and out of hospital quicker. They can often return to their own homes and not Nursing Care Homes

 

The My Improvement technology facilitated the session, it contained all the content we needed. Everyone enjoyed the group and afterwards patients were left to enjoy a social lunch. We are hoping to make this a permanent feature on Albert Ward.

We intend to continue working to explore the link between activity and nutrition and one of the physiotherapists is exploring the link between activity and compliance in a rehabilitation setting. Overall we have found the technology to be versatile and positive and suitable for use in acute settings.

We feel that there is real scope for using the units with patients suffering from delirium, as well as dementia and also extend the scope of use in the dialysis unit.

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Royal College of Nursing

My Improvement Network are committed to investing in education for health care professionals and are proud supporters of RCN Projects

The integration and use of technology within healthcare offers significant benefits in both primary and secondary care settings. These benefits can extend across nursing practice from improving person centered care to enhancing daily workflows. Providing educational tools that empower and guide nursing staff through this digital revolution is critical and will help facilitate successful incorporation and safe implementation of technologies within nursing, by nurses.