In a general hospital are older people with cognitive impairment managed better in a specialist unit?
Award Number
PB-PG-0110-21229Programme
Research for Patient BenefitStatus / Stage
CompletedDates
2 June 2011 -31 May 2013
Duration (calculated)
01 years 11 monthsFunder(s)
NIHRFunding Amount
£230,555.00Funder/Grant study page
NIHRContracted Centre
Nottingham University Hospitals NHS TrustPrincipal Investigator
Professor Sarah GoldbergPI Contact
sarah.goldberg@nottingham.ac.ukPI ORCID
0000-0001-5109-798XWHO Catergories
Models across the continuum of careTools and methodologies for interventions
Disease Type
Dementia (Unspecified)CPEC Review Info
| Reference ID | 147 |
|---|---|
| Researcher | Reside Team |
| Published | 12/06/2023 |
Data
| Award Number | PB-PG-0110-21229 |
|---|---|
| Status / Stage | Completed |
| Start Date | 20110602 |
| End Date | 20130531 |
| Duration (calculated) | 01 years 11 months |
| Funder/Grant study page | NIHR |
| Contracted Centre | Nottingham University Hospitals NHS Trust |
| Funding Amount | £230,555.00 |
Abstract
Cognitive impairment among older patients on acute hospital wards in the UK is common: we have found a prevalence of 30%. Yet there are concerns that the hospital care of older people with cognitive impairment is poor. NUH NHS Trust has developed a specialist medical and mental health unit (MMHU) aimed at improving care for these patients. The MMHU has been designed to deliver what is current best practice: there has been further staff training, mental health nurses have joined the ward team, working practices with patients and their families have been adapted for their particular needs. Patient outcomes will be evaluated in 2010-2012 by a randomised controlled trial comparing the MMHU to standard care. A comparison of the quality of care on the MMHU to standard care is needed. The overall aim of this study is to improve the care of people with cognitive impairment in hospital. The objectives of this study will enable us to identify realistic areas in which staff can be trained to improve their care of this patient group. The objective are: 1) To compare the patient participants’ experiences on the medical and mental health unit to standard care in terms of: a) mood and engagement b) time spent in active and passive behaviour c) the quality of staff interactions with patients. 2) To describe how care is delivered on the MMHU compared to standard care wards. Plan of Investigation This study has a mixed methods design. It will take 2 years. 1) Participants will be randomly sampled from an ongoing RCT comparing the MMHU to standard care. Experiences of care will be measured using Dementia Care Mapping, a structured observation tool that can produce measures of mood and engagement of participants, their activity, and the quality of staff interactions. 2) Field notes taken during Dementia Care Mapping will be analysed qualitatively to provide a description of how the MMHU differs from standard care and to identify good and poor practice. 3) Recommendations for training and management intervention based on the findings will be made. Potential Impact This project addresses issues of huge health and economic impact: 30% of older people in hospital have cognitive impairment from dementia or delirium. Whilst it is widely recognised that their care is sub-optimal in terms of a poor experience, there is little research evidence describing the problem, or evaluating ways to improve care. Improving this position is important for many health policies, notably standards 4 (general hospital care) and 7 (mental health) of the National Service Framework for Older People, and objective 8 of the National Dementia Strategy. This study will produce findings that will be immediately implementable both locally in the Trust which provides the study setting and more widely throughout the NHS, leading to rapid improvement in the quality of experience.
Aims
The overall aim of this study is to improve the care of people with cognitive impairment in hospital. The objectives of this study will enable us to identify realistic areas in which staff can be trained to improve their care of this patient group. The objective are: 1) To compare the patient participants’ experiences on the medical and mental health unit to standard care in terms of: a) mood and engagement b) time spent in active and passive behaviour c) the quality of staff interactions with patients.2) To describe how care is delivered on the MMHU compared to standard care wards. Plan of Investigation This study has a mixed methods design. It will take 2 years. 1) Participants will be randomly sampled from an ongoing RCT comparing the MMHU to standard care. Experiences of care will be measured using Dementia Care Mapping, a structured observation tool that can produce measures of mood and engagement of participants, their activity, and the quality of staff interactions.