Caring for Cognitive Impairment at St John of God Murdoch Hospital
St John of God Murdoch Hospital has embraced the concepts of the Caring for Cognitive Impairment campaign, making big improvements through the use of a multidisciplinary team approach.
Strategies that made a difference
A multidisciplinary working party was established to look at cognitive screening and how to best recognise and respond to patients with cognitive impairment. This led to a whole hospital approach and involvement in screening and recognising cognitive impairment, some strategies implemented as part of this included:
- Implementing the validated 4AT assessment test for delirium and cognitive impairment
- Development of a range of policies, outlining requirements for cognitive impairment screening and care
- Staff education about delirium and the 4AT assessment test for delirium and cognitive impairment
- Hospital-wide focus on providing high quality care for patients with cognitive impairment through increasing awareness about the Caring for Cognitive Impairment campaign and hospital initiatives.
Issues and problems faced?
Prompt identification of cognitive impairment at patient admission points can be challenging. Increasing staff education and confidence in recognising and diagnosing delirium early in the acute care setting has been paramount to improve cognitive impairment diagnosis.
Where to from here?
- Review of the current policy and practice for managing patients with delirium with a view of best practice and safe care management strategies will occur in 2017
- Work to ensure a more seamless connection between hospital policies, related risk assessment tools and associated actions. For example, communicating that a person with cognitive impairment is at a high risk of a fall and longer hospital stay in the policy for patient falls.
- Working at an executive level to consider patients and carers discharge needs and possible support that can be provided.
- Continued education for staff about cognitive impairment and links to the current and upcoming version 2 of the National Safety and Quality Health Service Standards.
St John of God Murdoch Hospital was granted ethics approval to conduct research into the prevalence of cognitive impairment in an acute hospital setting, which will occur during 2017.
Helpful hints for others
- Ensure policies and strategies are evidence based where possible, and break up their implementation into workable stages.
- The use of a multidisciplinary team was excellent and ensured whole of hospital involvement.
- Think of cognitive impairment as another vital sign that needs to be assessed, monitored and evaluated.
- Consider the impact points and develop a strategy to address gaps as a means to ensure patient safety and reduced length of stay.