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Improving the care of people with dementia in general hospitals: evaluation of a whole-system train-the-trainer model

Sampson, EL; Vickerstaff, V; Lietz, S; Orrell, M; (2017) Improving the care of people with dementia in general hospitals: evaluation of a whole-system train-the-trainer model. International Psychogeriatrics , 29 (4) pp. 605-614. 10.1017/S1041610216002222. Green open access

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Abstract

BACKGROUND: There are concerns about the quality of care that people with dementia receive in the general hospital. Staff report a lack of confidence and inadequate training in dementia care. METHODS: A train-the-trainer model was implemented across eight acute hospital trusts in London via a large academic health and science network. Impact was evaluated using mixed methods. Data were collected at (a) individual level: "Sense of Competence in Dementia Care" (SCID), (b) ward level: Person Interaction and Environment (PIE) observations, (c) organization level: use of specific tools, i.e. "This Is Me," (d) systems level: numbers and types of staff trained per trust. Results were analyzed with descriptive statistics and paired t-test with thematic framework analysis for PIE observations. RESULTS: The number of staff trained per trust ranged from 67 to 650 (total 2,020). A total of 1,688 (85%) baseline questionnaires and 456 (27%) three month follow-up questionnaires were completed. Mean SCID score was 43.2 at baseline and 50.7 at follow-up (paired t-test, p < 0.001). All sub-scales showed a small increase in competence, the largest being for "building relationships." Organizational level data suggested increased use of carer's passport, "This Is Me" documentation, dementia information leaflets, delirium screening scales, and pathways. PIE observations demonstrated improved staff-patient interactions but little change in hospital environments. CONCLUSIONS: There was a significant improvement in staffs' sense of competence in dementia care and the quality of interactions with patients. More hospitals adopted person-centered tools and pathways. Work is required to investigate if these changes improve hospital outcomes for people with dementia.

Type: Article
Title: Improving the care of people with dementia in general hospitals: evaluation of a whole-system train-the-trainer model
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S1041610216002222
Publisher version: http://dx.doi.org/10.1017/S1041610216002222
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Dementia, education, inpatient, liaison, training
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/1534472
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