scholarly journals Evaluation and Effectiveness of a Two-Day Dementia Training Program for Hospital Staff Working in an Emergency Department

2021 ◽  
pp. 1-14
Author(s):  
Julia Schneider ◽  
Jennifer Miller ◽  
Winfried Teschauer ◽  
Andreas Kruse ◽  
Birgit Teichmann
Keyword(s):  
Emergency Department ◽  
Organizational Performance ◽  
Training Program ◽  
Qualitative Content Analysis ◽  
Hospital Setting ◽  
Hospital Staff ◽  
Individual Performance ◽  
Working Environment ◽  
Structured Interviews ◽  
People With Dementia

Background: Entering the hospital via an emergency department (ED) is a pivotal moment in the life of people with dementia (PwD) and often starts an avoidable downward spiral. Therefore, it is required to further educate ED staff to raise awareness of the needs of PwD. Although there are many studies about existing dementia training programs for the hospital setting, empirical evidence for the ED setting and cross-level training evaluations are lacking. Objective: The study aims to evaluate a two-day dementia training course for ED staff on the outcome levels of learning, individual performance, and organizational performance. Furthermore, the study examines whether the training fulfilled participants’ expectations. Methods: Mixed methods were used to assess data from head nurses, nursing, and administrative staff working in EDs. We conducted semi-structured interviews three weeks before (N = 18) and eight months after (N = 9) the training. Questionnaire data were assessed before the training, three months, and six months after the training (N = 44). A qualitative content analysis was conducted to analyze qualitative data; quantitative data was described descriptively. Results: The intervention seems to be effective on both learning and individual performance levels. However, we did not observe any changes in the organizational performance. The training program met attendees’ expectations only partly. The working environment of EDs needs to be taken more into account. Conclusion: Hospital staffs’ expectations of a dementia training program depend on the work area in which they operate. Results support the implementation of intervention bundles to enable sustainable cross-level changes.

Working with older people with dementia: motivations and demotivations among health carers

2019 ◽  
Vol 23 (3) ◽  
pp. 117-126
Author(s):  
Sara Cheloni ◽  
Anthea Tinker
Keyword(s):  
Healthcare Professionals ◽  
Hospital Setting ◽  
Personal Characteristics ◽  
Intention To Leave ◽  
Working Environment ◽  
Staff Retention ◽  
Structured Interviews ◽  
Content Type ◽  
Staff Motivation ◽  
People With Dementia

Purpose Motivation is central to the ongoing professional development, performance and retention of healthcare workers. Despite the increasing prevalence of people with dementia (PwD) and the associated demand for geriatric nurses, there exists a paradoxical shortage. The purpose of this paper is to explore the motivation and demotivation of healthcare professionals for working with older PwD, challenges faced, factors influencing intention to leave the field of work and methods to enhance staff motivation to continue working with this group. Design/methodology/approach This grounded-theory study used thematic analysis to synthesise data from 13 semi-structured interviews relating to the motivating and demotivating factors of healthcare professionals (nurses and healthcare assistants) for working with older PwD in a hospital setting. Findings Staff were motivated by previous personal experiences, personal characteristics and the fulfilment of the carer–patient relationship. Conversely, staff were mostly demotivated by organisational and working environment factors (e.g. poor leadership characteristics, inadequate staffing levels, lack of development opportunities), negatively influencing their intention to remain in employment. Research limitations/implications The generalisability of the results is limited by the size of the sample. Different organisational strategies/interventions (i.e. support, training, recognition and rewards) are necessary to nurture staff motivation, improve retention, create positive working environments and enhance patient care. Originality/value This study offers numerous ways in which to address factors contributing to demotivation in working with PwD, thereby helping to improve staff retention and support the needs of a growing population.

scholarly journals Effects of a Person Centered Dementia Training Program in Greek Hospital Staff—Implementation and Evaluation

2020 ◽  
Vol 10 (12) ◽  
pp. 976
Author(s):  
Mara Gkioka ◽  
Birgit Teichmann ◽  
Despina Moraitou ◽  
Sotirios Papagiannopoulos ◽  
Magda Tsolaki
Keyword(s):  
Training Program ◽  
Health Care Professionals ◽  
Repeated Measures ◽  
Hospital Staff ◽  
Individual Performance ◽  
Organizational Level ◽  
General Hospitals ◽  
Staff Members ◽  
People With Dementia ◽  
Over Time

People with Dementia (PwD) are frequently admitted in general hospitals. However, health care professionals have lack of dementia knowledge, negative attitudes toward dementia, and lack of confidence in caring those patients. The aim of this study is to develop, implement and evaluate a dementia staff training program in Greek general hospitals. It was a repeated-measures research design. Fourteen (14) two-day workshops were conducted, consisting of six targeted and interactive modules. Staff members (N = 242) attended the program and were assessed according to (1) individual performance: questionnaires about attitudes towards dementia, confidence in care, knowledge about dementia and anxiety before, immediately after the training and three months later, (2) an overall training evaluation immediately after the training and (3) an evaluation of training implementation three months later. Positive attitudes towards dementia, improvement of confidence in care and decrease of feeling of anxiety as a trait, were sustained over time. Knowledge about dementia also increased after the training and sustained, with, however, a slight decrease over time. A well applied training program seems to provide the basis of a better care in PwD during hospitalization. However, changes in the organizational level and a transformation of care culture are necessary for training sustainability over time.

scholarly journals Improving emotional well-being for hospital-based patients with dementia

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Stephanie Petty ◽  
Amanda Griffiths ◽  
Donna Maria Coleston ◽  
Tom Dening
Keyword(s):  
Nursing Staff ◽  
Hospital Care ◽  
Personal Information ◽  
Hospital Setting ◽  
Well Being ◽  
Hospital Staff ◽  
Content Type ◽  
Hospital Nursing ◽  
People With Dementia ◽  
Hospital Resources

Purpose Improving hospital care for people with dementia is a well-established priority. There is limited research evidence to guide nursing staff in delivering person-centred care, particularly under conditions where patients are emotionally distressed. Misunderstood distress has negative implications for patient well-being and hospital resources. The purpose of this study is to use the expertise of nurses to recommend ways to care for the emotional well-being of patients with dementia that are achievable within the current hospital setting. Design/methodology/approach A qualitative study was conducted in two long-stay wards providing dementia care in a UK hospital. Nursing staff (n = 12) were asked about facilitators and barriers to providing emotion-focused care. Data were analysed using thematic analysis. Findings Nursing staff said that resources existed within the ward team, including ways to gather and present personal information about patients, share multidisciplinary and personal approaches, work around routine hospital tasks and agree an ethos of being connected with patients in their experience. Staff said these did not incur financial cost and did not depend upon staffing numbers but did take an emotional toll. Examples are given within each of these broader themes. Research limitations/implications The outcome is a short-list of recommended staff actions that hospital staff say could improve the emotional well-being of people with dementia when in hospital. These support and develop previous research. Originality/value In this paper, frontline nurses describe ways to improve person-centred hospital care for people with dementia.

scholarly journals Hospital Staff’s Attitudes Toward and Knowledge About Dementia Before and After a Two-Day Dementia Training Program

2020 ◽  
Vol 77 (1) ◽  
pp. 355-365 ◽  
Author(s):  
Julia Schneider ◽  
Anton Schönstein ◽  
Winfried Teschauer ◽  
Andreas Kruse ◽  
Birgit Teichmann
Keyword(s):  
Training Program ◽  
Attitude Change ◽  
Challenging Behavior ◽  
Hospital Staff ◽  
Attitude Scale ◽  
Positive Trend ◽  
Long Term Effects ◽  
Targeted Interventions ◽  
People With Dementia

Background: The outcomes of hospitalized People with Dementia (PwD) are likely to be negative due to, among other key causes, negative staff attitudes and limited staff knowledge regarding dementia. Targeted interventions have been shown to positively change the attitudes of the hospital staff while also increasing their overall knowledge of dementia. However, training effects are often short-lived and frequently long-term effects are not examined in studies. Objective: To examine whether attending a dementia training program changes the attitudes of hospital staff toward PwD and/or increases their knowledge levels about dementia, and whether or not these changes are stable. Methods: The training program lasted two days and N = 60 attending hospital staff members agreed to participate in the study. Data were assessed with questionnaires prior to the training, 3 months, and 6 months after the training. German versions of the Dementia Attitude Scale (DAS-D) and the Knowledge in Dementia (KIDE) scale were used. Additionally, data about perception of PwD and confidence in dealing with challenging behavior were collected and analyzed. Results: After the training program, participants showed a significantly better attitude toward PwD as measured by DAS-D. These time-effects occurred in both DAS-D subscales (“dementia knowledge” and “social comfort”). Although a positive trend could be seen in the KIDE scale, no statistically significant increase occurred over time. Conclusion: Specialist training programs seem to be promising in positively changing attitudes toward and increasing knowledge about PwD with long-term effects. Further research should address the effects of attitude change in patient care.

scholarly journals Dementia Friendly Hospital Design: Key Issues for Patients and Accompanying Persons in an Irish Acute Care Public Hospital

2019 ◽  
Vol 13 (1) ◽  
pp. 48-67 ◽  
Author(s):  
Dimitra Xidous ◽  
Tom Grey ◽  
S. P. Kennelly ◽  
Cathy McHale ◽  
Desmond O’Neill
Keyword(s):  
Older People ◽  
Negative Impact ◽  
Spatial Scales ◽  
Hospital Setting ◽  
Hospital Environment ◽  
Multiple Perspectives ◽  
Structured Interviews ◽  
People With Dementia ◽  
Person With Dementia ◽  
The Impact

Objectives: Research was conducted to investigate the impact of the hospital environment on older people including patients with dementia and their accompanying persons (APs). The article presents key research findings in the case study hospital. Background: For many patients, the hospital is challenging due to the busy, unfamiliar, and stressful nature of the environment. For a person with dementia, the hospital experience can be exacerbated by cognitive impairment and behavioral or psychological symptoms and can therefore prove to be a frightening, distressing, and disorientating place. Method: The findings are based on a stakeholder engagement process where the research team spent approximately 150 hr observing within the hospital, administered 95 questionnaires to patients and/or APs, and conducted 12 structured interviews with patients and APs. A thematic analysis was employed to analyze and generate key themes emerging from the process. Results: Themes were grouped into overarching issues and design issues across spatial scales. Conclusion: This research confirms the negative impact of the acute hospital setting on older people with cognitive impairments including dementia and delirium. The multiple perspectives captured in this study, including most importantly people with dementia, ensure that stakeholder needs can be used to inform the design of the hospital environment. The research points to the value of understanding the lived experience of the person with dementia and APs. The voices of patients, particularly persons with dementia and their APs, are a crucial element in helping hospitals to fulfill their role as caregiving and healing facilities.

Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care

2016 ◽  
Vol 29 (3) ◽  
pp. 467-474 ◽  
Author(s):  
Joanne Tropea ◽  
Dina LoGiudice ◽  
Danny Liew ◽  
Carol Roberts ◽  
Caroline Brand
Keyword(s):  
Best Practice ◽  
Quality Care ◽  
Hospital Setting ◽  
Hospital Staff ◽  
Dementia Care ◽  
Perceived Barriers ◽  
Barriers And Enablers ◽  
People With Dementia ◽  
Multidisciplinary Staff ◽  
Survey Responses

ABSTRACTBackground:Best practice dementia care is not always provided in the hospital setting. Knowledge, attitudes and motivation, practitioner behavior, and external factors can influence uptake of best practice and quality care. The aim of this study was to determine hospital staff perceived barriers and enablers to implementing best practice dementia care.Methods:A 17-item survey was administered at two Australian hospitals between July and September 2014. Multidisciplinary staff working in the emergency departments and general medical wards were invited to participate in the survey. The survey collected data about the respondents’ current role, work area, and years of experience, their perceived level of confidence and knowledge in dementia care and common symptoms of dementia, barriers and enablers to implementing best practice dementia care, job satisfaction in caring for people with dementia, and to rate the hospital's capacity and available resources to support best practice dementia care.Results:A total of 112 survey responses were received. The environment, inadequate staffing levels and workload, time, and staff knowledge and skills were identified as barriers to implementing best practice dementia care. Most respondents rated their knowledge of dementia care and common symptoms of dementia, and confidence in recognizing whether a person has dementia, as moderate or high dementia. Approximately, half the respondents rated access to training and equipment as low or very low.Conclusion:The survey findings highlighted hospital staff perceived barriers to implementing best practice dementia care that can be used to inform locally tailored improvement interventions.

scholarly journals Training Needs of Practice Facilitators When Implementing An Opioid Improvement Initiative in Primary Care

2021 ◽  
Author(s):  
Michael L. Parchman ◽  
Brooke Ike ◽  
Katie Osterhage ◽  
Ashley Johnson ◽  
Laura-Mae Baldwin
Keyword(s):  
Primary Care ◽  
Training Program ◽  
Peer Relationships ◽  
Qualitative Content Analysis ◽  
Medication Management ◽  
Building Blocks ◽  
Training Needs ◽  
Evidence Based ◽  
Structured Interviews ◽  
Evidence Based Programs

Abstract Background: Practice facilitation is a commonly employed strategy to implement evidence-based programs into primary care settings. Preparing facilitators for this role requires an understanding of their training needs and support. Here we report on the experiences of facilitators who participated in a training program to support efforts to improve opioid medication management in primary care.Methods: Trainees with prior QI experience were recruited for the six-month training program. Each trainee recruited a clinic for which they would serve as an external facilitator to implement the Six Building Blocks program. At the end of the six-months, we conducted two semi-structured interviews with each trainee. The interviews focused on facilitators and barriers that the trainees experienced during the training and support provided. Qualitative content analysis was used to analyze the transcribed interviews.Results: Three of the five trainees completed the program. In addition to the in-depth understanding of the Six BB program, trainees valued the opportunity to build peer relationships which provided a supportive peer support group. They valued the availability of more experienced facilitators who supported and mentored them. They also mentioned the importance of providing helpful tools and resources and the availability of a clinical expert. Barriers focused on factors internal to the trainees’ clinical setting, the trainees limited clinical knowledge about chronic pain, and difficulty maintaining momentum for change due to the flexible timeline of the program itself.Conclusions: In addition to training on the content of an evidence-based programs, facilitators valued work with supportive peers and the mentoring of more experienced facilitators. Primary care improvement initiatives employing practice facilitators should consider these training needs and the resources required for this supportive infrastructure.

scholarly journals Motivation Factors Affecting the Job Attitude of Medical Doctors and the Organizational Performance of Public Hospitals in Warsaw, Poland

2020 ◽  
Author(s):  
Malgorzata Chmielewska ◽  
Jakub Stokwiszewski ◽  
Justyna Filip ◽  
Tomasz Hermanowski
Keyword(s):  
Organizational Performance ◽  
Performance Feedback ◽  
Hospital Setting ◽  
Individual Performance ◽  
Public Hospitals ◽  
World Health ◽  
Healthcare Sector ◽  
Social Aspect ◽  
Medical Doctors ◽  
Motivation Factors

Abstract Background: This paper explores the relationship between organizational performance of hospitals and selected motivation factors that affect the attitude to work among medical doctors at public hospitals.Methods: This study was based on World Health Organization questionnaires designed to estimate motivation factors and to measure the levels of organizational performance of hospitals in the social aspect. A survey was conducted among physicians (N=249) with either surgical or non-surgical specialty, in 22 departments/units of general public hospitals in Warsaw (Poland).Results: The survey revealed that motivation factors related to “quality and style of supervision” have the greatest impact on the hospital’s organizational performance (Spearman's rank correlation coefficient = 0.490; p<0.001), whereas “performance feedback” was rated the lowest among the surveyed healthcare professionals (54% of physicians). Conclusion: The principles of Individual Performance Review should be incorporated into strategies designed to improve the organizational performance of hospitals (with NHS serving as a role model) in order to establish specific rules on how to share performance feedback among individual physicians. This study makes a research contribution to literature on human resource management in the healthcare sector, highlighting the importance of social aspects in improving organizational performance in a hospital setting.

scholarly journals Effectiveness of Individual Performance Dialogue on Employee Performance (Case Studies on Civil Servants of the Ministry of Finance in City of Semarang)

2021 ◽  
Vol 6 (1) ◽  
pp. 58-74
Author(s):  
Ni Made Watimena Sudiarti ◽  
Edi Noersasongko ◽  
Yuventius Tyas Catur Pramudi
Keyword(s):  
Organizational Performance ◽  
Performance Management ◽  
Management Practices ◽  
Employee Performance ◽  
Individual Performance ◽  
Partial Least Square ◽  
Least Square ◽  
Structured Interviews ◽  
Ministry Of Finance ◽  
Bureaucratic Reform

Bureaucratic Reform in human resources began with the birth of Law No. 5 of 2014 on State Civil Apparatus (ASN). The new paradigm in the ASN Law makes ASN employees a profession that has an obligation to conduct self-development and must take responsibility for performance and apply merit principles in the implementation of ASN management. The Ministry of Finance followed up the Bureaucratic Reform in hr with performance management policies. Performance management in the Environment of the Ministry of Finance consists of three main stages, namely planning, monitoring, and determining performance results and evaluation.  Performance evaluation results determine the performance value of employees and organizations, which affects employee careers and compensation. The solution by the Ministry of Finance is to implement management practices called Organizational Performance Dialogue (DKO) and Individual Performance Dialogue (DKI) whose main purpose is to improve the performance of employees and organization. This research is explanatory, where the research method used is Partial Least Square (PLS), with software for analysis using SmartPLS. Data collection instruments using questionnaires and structured interviews with research respondents are employees of the Ministry of Finance in Semarang City area. This research aims to know the effectiveness of performance dialogue on employee performance, so that the results are expected to be a reference in management practices in organizational units in the environment of the Ministry of Finance in an effort to improve the performance of employees and organizations. Keywords:Effectiveness, Individual factors, Leadership factors, Performance dialogue, Employee performance

scholarly journals Understanding and identifying ways to improve hospital-based cancer care and treatment for people with dementia: an ethnographic study

2020 ◽  
Author(s):  
Laura Ashley ◽  
Rachael Kelley ◽  
Alys Griffiths ◽  
Fiona Cowdell ◽  
Ann Henry ◽  
...  
Keyword(s):  
Cancer Care ◽  
Treatment Decision ◽  
Hospital Staff ◽  
Ethnographic Study ◽  
Cancer Information ◽  
Structured Interviews ◽  
Global Challenge ◽  
Treatment Decision Making ◽  
People With Dementia ◽  
Care And Treatment

Abstract Background Providing cancer care and treatment for ageing populations with complicating comorbidities like dementia is a growing global challenge. This study aimed to examine the hospital-based cancer care and treatment challenges and support needs of people with dementia, and identify potential ways to address these. Methods A two-site ethnographic study in England involving semi-structured interviews, observations and accompanying conversations, and medical record review. Participants (N = 58) were people with dementia and comorbid cancer (n = 17), informal caregivers (n = 22) and hospital staff (n = 19). Ethnographically informed thematic analysis was conducted. Results There was an accumulated complexity of living with both illnesses simultaneously. People with dementia and families could feel confused and uninformed due to difficulties understanding, retaining and using cancer information, which impacted their informed treatment decision-making. Dementia increased the complexity and burden of travelling to and navigating unfamiliar hospital environments, frequent lengthy periods of waiting in hospital, and self-managing symptoms and side-effects at home. Oncology staff were often working without the full picture, due to variable documenting of dementia in medical records, dementia training was limited, and time and resource pressures impeded the highly individualised, flexible cancer care required by people with dementia. Supportive family carers were crucial in enabling people with dementia to access, navigate and undergo cancer treatment and care. Conclusions Dementia complicates cancer care in a range of ways accumulating across the cancer pathway. Our findings suggest there are several strategies and interventions, which we list here, with potential to improve cancer care and treatment for people with dementia and their families.

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