Reducing falls with stimulation Albert Ward Reducing falls with stimulation Albert Ward St Marys Hospital Katie Pritchard: Ward Manager. Hannah Stephens: Dementia Therapy assistant.

WELCOME TO ALBERT WARD

Pre intervention Post intervention Awarded ‘WHITE’ on Ward Accreditation Programme (the lowest possible score). New ward manager appointed. Post intervention Awarded GOLD on the Ward Accreditation programme! The concerns for the ward were highlighted in the Ward Accreditation programme. To quote some serious concerns: There was no shared vision between nursing, therapies and other staff around the vision and aims for the ward, particularly given that it a rehabilitation ward. Falls risk documentation had been inaccurately documented.

What we observed: WAP feedback Poor sleep wake cycles High incidence of falls at night Patients reporting feelings of boredom and frustration. Staff burn out Poor oral intake Poor feedback on the friends and family test WAP feedback

The need for change! On top of all the other feedback from WAP, we also needed to drastically transform: Staff morale Patient experience Ward based stimulation for patients, especially those with dementia. On top of everything that needed correcting for the ward WAP, there was also other aspects that needed attention and the realisation of a new role. Ward manager couldn’t do this alone, needed assistance.

DEMENTIA THERAPY ASSISTANT Creating job description. DEMENTIA THERAPY ASSISTANT Finding the right candidate. Funding for the role.

Dementia Therapy Assistant and the impact on falls reduction Dementia Therapy Assistant and the impact on falls reduction. How will we achieve this? Here talk about each point and the overall connection between stimulation and sleep wake cycle.

Action plan to engage our patients! The benefits of fresh air!

Meet Mrs B On admission to Albert Ward: Would not engage with therapy staff. Bedbound. Did not want to even discuss the amputee gym, never mind attend. Very passive, would make minimal eye contact. Slowly gained trust whilst an inpatient. Eventually convinced to practice transfers to wheelchair. Consent to going outside for fresh air in wheelchair. Would then go out daily in wheelchair, independently. Attended amputee gym. Now mobilising with two sticks with prosthesis.

STIMULATION! Discovering what is already available in the Trust MDT approach, utilising feedback from nursing survey.

Music therapy, Socialising! Art Therapy, Music therapy, Socialising!

Quality Improvement Project Winners!  ”We were impressed at the huge efforts taken by the teams to deliver on their Quality Improvement projects at phase two. Some projects have shown immense progress and creativity. The Sponsors grouped and rated the projects in two categories -  Winner and Highly recommended.   The criteria for winner demonstrated ·         Staff/Patient engagement ·         MDT engagement ·         Project team in place ·         Well Led ·         Uses QI methodology ·         Ahead of schedule ·         Clear Measures of Improvement ·         Clear patient benefits ·         Scope for share and spread ·         Addresses WAP concern I am happy to announce ALBERT ward as the  WINNER for phase 2 of this process. Congratulations Katie, to you and your team on your success to date. “

The benefits of using My Improvement Network. On ward entertainment available at all hours, individually or as a group. Does not exclude patients in side rooms. Projector fantastic for group activities. Engages both patients and staff. Karaoke, games, films, patient collages, relaxation have been particularly beneficial on Albert.

Making it fun. Christmas card making with My Improvement network!

Involving the entire MDT: Mention here about visiting hours and the fact that we are very relaxed on them. Have a clinic that nursing staff and ward admin book patients into. Mention here about visiting hours and the fact that we are very relaxed on them. Have a clinic that nursing staff and ward admin book patients into.

The benefits of carers: Recent QI project and the cards

Co working with existing charities Importance of linking in with already established charities. Alzheimer's society RedCross

Audited improvements 1) Increase in the number of patients sat out of bed for lunch. Figure 1 shows the number of patients sat out of bed and in their chairs for lunch time. It compares data from pre and post intervention over a three month period.

Night time falls on Albert Ward. 2) Reduction in falls! Night time falls on Albert Ward.

3) Patient experience as seen on Friends and family test. “ I suddenly realised that I haven’t smiled like this for a long time!” (In response to the music) something I never expected to hear in hospital! The most pleasant surprise”. “ It really cheered me up, I haven’t heard some of those songs for years and it bought back very happy memories!”

“How very kind of you to take the trouble, not only to write with news of my mother, but also to send the video clip of her having a bit of fun. I was so upset to see her in such a bad way on Wednesday morning and I have been so worried about her welfare and happiness. I cannot tell you just how grateful I am for all your kindness help and support in making her feel better about herself and her future. I want to thank you and your team so very much for all your loving care.” Hospital visits are helping to bring the museum to the patients Museum visits facilitated by Imperial Health Charity are making a huge difference for patients on the Albert Ward, allowing them to learn, discuss and reminisce with others. “It’s a complete change of scenery; it’s stimulating and gets you out of your own problems.”

Any questions?