Royal Devon & Exeter Hospital

The Royal Devon & Exeter Hospital is committed to providing excellent care for all our patients but has made an additional pledge to become a dementia friendly hospital. We are currently revising our new three year dementia strategy and action plan to ensure our services can meet the needs of this patient group and their families. It includes a robust audit plan against our actions to ensure we can monitor practice and improve standards of care. This strategy is also designed to meet the needs of any patient who is cognitively impaired for whatever reason. We are aware that patients who have a diagnosed dementia are likely to be at risk of an acute delirium early on in their hospital journey which can place them at significant risk and cause a great deal of distress for both the patient and their family. We have designed our services to meet the needs of this group by ensuring all our staff are aware of both dementia and delirium as well as reflecting this in our strategy and associated actions.

Updated:
11 May 2016
Location:
South West
Sectors:
Hospitals and Hospital Trusts
Local Alliances:
Exeter Dementia Action Alliance (EDAA)

1. Action Plan

1. The National Dementia Declaration lists seven outcomes that the DAA are seeking to achieve for people with dementia and their carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

Action 1:     

Dementia and delirium training for every staff member

Description:

We recognise that every staff member requires awareness of dementia and delirium to support our patients, cares and other staff members.  By training every member of staff, regardless of their role, will help to create and sustain a caring and compassionate environment for our patients, as well as our own staff.   Our objective is to achieve 95% compliance during this three year period.

Action 2:     

Title:   Better support for carers. 

Description:  

We recognise that those who care for someone with dementia are experts in that person’s care and will be the best person to help them feel safe in a strange place. However they can feel excluded from their care once in hospital which can cause the patient to feel isolated, frightened and have a poor clinical outcome.  Our objective is for all clinical areas to understand how to recognise a carer, what their needs might be and how to support them during the patient’s journey in hospital.  

Action3: 

Care will be patient centred with a dementia bundle available in all clinical areas to support the patient and their carers.  

Description: 

A dementia bundle will be available for every clinical area to include a dementia and delirium care plan, “This is Me” document, blue wrist band, a magnetic symbol for ward whiteboards and patient  bedside, useful contacts and information for carers.  Where appropriate to safeguard patients at risk of abuse inter-agency sharing of information will occur, taking into account patient wishes.

In addition to these three actions, in our three year strategy we will be working towards;

• Staff training in dementia and delirium for every staff member
• Improved support for carers
• Improved staff training in de-escalation techniques
• Monitoring of anti-psychotic medication
• Dementia champions in acute areas
• Access to written information for patients and their carers
• Introduction of a dementia bundle for wards
• Improved access to psychiatric liaison
• Regular audits of patients with dementia in line with the national audit of dementia. 
• Improved access to patient activities  
• To reduce bed moves unless their clinical condition requires it.    
• Improved access to finger foods
• Improved end of life care and support
• Increase in volunteers
• Join John’s campaign
• Start activities on the wards for patients with dementia

2. What are the challenges to delivering these outcomes from the perspective of your organisation?

Trying to achieve our objectives in a large organisation of 7,000 staff will mean that some of these changes will take time to develop and implement. However we have good governance structures in place which are designed to monitor our compliance to improve care, safety and risk to all our patients.

 In the current economic climate there will be a number of funding issues relating to some of our objectives which will need to be prioritised against other competing clinical issues.

We have a new three strategy for dementia and delirium which has a comprehensive action plan which is designed to help overcome these challenges by providing evidence through audit of care and other methods. 

 

Member website

www.rdehospital.nhs.uk

2. Actions

  • Dementia and delirium training for every staff member

    We recognise that every staff member requires awareness of dementia and delirium to support our patients, cares and other staff members.  By training every member of staff, regardless of their role, will help to create and sustain a caring and compassionate environment for our patients, as well as our own staff.   Our objective is to achieve 95% compliance during this three year period.

     

    Status:
    Being implemented
  • Better support for carers

    We recognise that those who care for someone with dementia are experts in that person’s care and will be the best person to help them feel safe in a strange place. However they can feel excluded from their care once in hospital which can cause the patient to feel isolated, frightened and have a poor clinical outcome.  Our objective is for all clinical areas to understand how to recognise a carer, what their needs might be and how to support them during the patient’s journey in hospital.  

    Status:
    Being implemented
  • Care will be patient centred with a dementia bundle available in all clinical areas to support the patient and their carers.

    A dementia bundle will be available for every clinical area to include a dementia and delirium care plan, “This is Me” document, blue wrist band, a magnetic symbol for ward whiteboards and patient  bedside, useful contacts and information for carers.  Where appropriate to safeguard patients at risk of abuse inter-agency sharing of information will occur, taking into account patient wishes.

    Status:
    Being implemented