Improving Care for People With Dementia in Acute Care Settings

Dementia is the general term for a decline in mental ability or cognitive function severe enough to interfere with daily life (Alzheimer’s Association, 2017). In the United States, dementia has been classified as the sixth leading cause of death, and is the only disease within that category increasing in prevalence. Current literature suggests that acute care clinical staff who provide direct care for people with dementia do not feel adequately equipped or trained to manage this specialized patient population. The purpose of this project was to perform a local needs assessment and increase direct care provider’s knowledge, communication, and resources available for the management of behavioral and psychological symptoms of dementia.

Using the Dementia Knowledge Assessment Scale (DKAS) the current knowledge level of direct clinical staff was measured to identify knowledge gaps (Annear, et. al., 2015). Based on the identified gaps, a tailored computer based module was developed and implemented at a Midwestern academic hospital on a medical surgical unit, an orthopedic unit, and a trauma unit. The project developed and evaluated interdisciplinary documentation tools in conjunction with the tailored dementia training to support reinforcement of new practice and sustainability of newly gained knowledge and resources. This emphasis on resources to clinical staff provided a pathway for patient specific knowledge to be readily communicated between staff regarding intervention strategies to reduce behavioral and psychological symptoms of dementia.

After implementation of the computer based training and documentation tools, pilot units demonstrated a significant knowledge increase in the areas identified as low scoring topics during the DKAS knowledge assessment. This project provides evidence that the leveraging of technology, use of specialized clinical tools, and population specific resources such as the dementia banner and symptomatic behavior note in conjunction with tailored dementia education demonstrates promising progress in care for people with dementia in the acute care setting.