Acute hospital dementia care: results from a national audit

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dc.contributor.authorTimmons, Suzanne
dc.contributor.authorO'Shea, Emma
dc.contributor.authorO'Neill, Desmond
dc.contributor.authorGallagher, Paul F.
dc.contributor.authorde Siún, Anna
dc.contributor.authorMcArdle, Denise
dc.contributor.authorGibbons, Patricia
dc.contributor.authorKennelly, Sean
dc.contributor.funderAtlantic Philanthropiesen
dc.date.accessioned2017-02-23T17:57:49Z
dc.date.available2017-02-23T17:57:49Z
dc.date.issued2016-05-31
dc.date.updated2017-02-23T17:46:59Z
dc.description.abstractBackground: Admission to an acute hospital can be distressing and disorientating for a person with dementia, and is associated with decline in cognitive and functional ability. The objective of this audit was to assess the quality of dementia care in acute hospitals in the Republic of Ireland. Methods: Across all 35 acute public hospitals, data was collected on care from admission through discharge using a retrospective chart review (n = 660), hospital organisation interview with senior management (n = 35), and ward level organisation interview with ward managers (n = 76). Inclusion criteria included a diagnosis of dementia, and a length of stay greater than 5 days. Results: Most patients received physical assessments, including mobility (89 %), continence (84 %) and pressure sore risk (87 %); however assessment of pain (75 %), and particularly functioning (36 %) was poor. Assessment for cognition (43 %) and delirium (30 %) was inadequate. Most wards have access at least 5 days per week to Liaison Psychiatry (93 %), Geriatric Medicine (84 %), Occupational Therapy (79 %), Speech & Language (81 %), Physiotherapy (99 %), and Palliative Care (89 %) Access to Psychology (9 %), Social Work (53 %), and Continence services (34 %) is limited. Dementia awareness training is provided on induction in only 2 hospitals, and almost half of hospitals did not offer dementia training to doctors (45 %) or nurses (48 %) in the previous 12 months. Staff cover could not be provided on 62 % of wards for attending dementia training. Most wards (84 %) had no dementia champion to guide best practice in care. Discharge planning was not initiated within 24 h of admission in 72 % of cases, less than 40 % had a single plan for discharge recorded, and 33 % of carers received no needs assessment prior to discharge. Length of stay was significantly greater for new discharges to residential care (p < .001). Conclusion: Dementia care relating to assessment, access to certain specialist services, staffing levels, training and support, and discharge planning is sub-optimal, which may increase the risk of adverse patient outcomes and the cost of acute care. Areas of good practice are also highlighted.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid113
dc.identifier.citationTimmons, S., O’Shea, E., O’Neill, D., Gallagher, P., de Siún, A., McArdle, D., Gibbons, P. and Kennelly, S. (2016) 'Acute hospital dementia care: results from a national audit', BMC Geriatrics, 16, 113 (10pp). doi:10.1186/s12877-016-0293-3en
dc.identifier.doi10.1186/s12877-016-0293-3
dc.identifier.endpage10en
dc.identifier.issn1471-2318
dc.identifier.journaltitleBMC Geriatricsen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/3684
dc.identifier.volume16en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.rights© 2016, the Authors. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectDementiaen
dc.subjectQuality of careen
dc.subjectHospitalsen
dc.subjectAuditen
dc.subjectAssessmenten
dc.subjectAntipsychoticsen
dc.subjectDischarge planningen
dc.subjectSpecialist servicesen
dc.subjectStaff trainingen
dc.subjectPeopleen
dc.subjectDeliriumen
dc.subjectPainen
dc.subjectPrevalenceen
dc.subjectSymptomsen
dc.subjectNurseen
dc.subjectProfessionalsen
dc.subjectPerspectivesen
dc.subjectAgitationen
dc.subjectOutcomesen
dc.titleAcute hospital dementia care: results from a national auditen
dc.typeArticle (peer-reviewed)en
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