Cognitively impaired older patients' experiences of care on a medical and mental health unit compared to standard care wards in a general hospital: A controlled clinical trial
Schneider, Justine
Schneider, Justine
Abstract
Introduction: Nottingham University Hospital developed a Medical and Mental Health Unit (MMHU) as a demonstration model of best practice care for older people with cognitive impairment admitted to the hospital as a medical emergency. A randomised controlled trial (NIHR TEAM trial) is evaluating patient outcomes between the MMHU and standard care. The aim of this study was to compare patient experience between the MMHU and standard care. Methods: Patients were randomly sub-sampled from those randomised to the NIHR TEAM trial. Patient experience was measured, by two observers, using Dementia Care Mapping, a structured, non-participant observational tool. Using this method, every five minutes, for 6 hours, patients' apparent mood or level of engagement and activity was coded. Staff behaviours which met or disregarded the psychological needs of the patient were coded as enhancers or detractors. Environment noise was recorded (alarms/telephones, background noise, patients calling out). Observations were between 07:00 and 20:30. Inter-rater reliability was tested. Results: 90 observations (46 MMHU versus 44 standard care) were completed between March 2011 to December 2011. (Table presented) Conclusion: Patients had a better experience of care on the MMHU than on standard care wards. They spent more time in a positive mood, and experienced more enhancers. There was less ward noise; though more patients called out in distress on the MMHU.
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Date
2013
Type
Article
Subject
General hospital, Mental health services, Dementia, Hospital emergency service
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Citation
Goldberg, S. E., Gladman, J. R., Whittamore, K. H., Harwood, R. H. & Schneider, J. M. (2013). Cognitively impaired older patients' experiences of care on a medical and mental health unit compared to standard care wards in a general hospital: A controlled clinical trial. Age and Ageing, 42 (Supplement 2), pp.ii29.