3rd September 2020
Residents of a community nursing unit have been empowered to lead their own care in an environment where they can feel at home thanks to an award-winning initiative.
The ‘Excellence in Quality Care’ award at the HSE Health Service Excellence Awards was given to Clonskeagh Community Nursing Unit for its transformation into a ‘butterfly home’ to improve the lived experience of people living with dementia.
There are four private butterfly homes in Ireland; the one in Clonskeagh is the first HSE initiative.
It involved transformation from a Medical Model of Care to Social Care Model and reducing barriers (uniforms, languages, ‘them and us’ barriers) between residents and staff.
Vandana Iqbal, the Project Lead, said the aim of the project was to create a home where ‘feelings matters most’.
“People living with dementia cannot always understand what is going on, but the feeling of how you made them feel remains with them for hours. This project included environmental transformation from clinical outlook to creating homely welcoming spaces and transforming staff into butterflies delivering care to residents,” she said.
“The main challenge was to create an environment where people can feel at home and expert nursing care continues in the background. Recognition at the highest level and winning this award has assured that we are on the right path. Our dementia care journey has just begun and we are hopeful that the Clonskeagh team will continue their efforts in caring for their residents, empowering them in leading their own care.”
The project has improved the lived experience of people with a dementia in the unit. This project aligns with the National Dementia Care Strategy. It is a large-scale project – the facility includes 81 long-stay beds, nine respite beds, and 120 staff.
The project has assisted staff and families to gain an insight into dementia care increasing awareness of memory impairment and dementia.
One focus, for example, is on improved mealtime experience, with a lead into meals (creating smells offering appetisers) leading to improved appetites and residents starting to eat without assistance.
Dietician Maria McKenna explained, “The project encouraged staff to make changes which improved the quality of life of people that live in the CNU. One of the changes was improvement around mealtimes which involved a collaborative approach amongst all the team members. Mealtimes can be the most important part of a person’s day and the butterfly project highlighted the importance of the dining experience.
“The project highlighted the passion and enthusiasm staff have for patient centred care and it was great to have this acknowledged by receiving the award,” said Maria.
As well as the positive results around mealtimes, there has been a reduction in psychotropic medication to control behaviours. Only four residents out of 81 now on psychotrophic medication compared to a previous figure of 50%.
There has also been a 20% reduction in wheelchair usage.
The judges commented that the team showed significant drive at local level and demonstrated ‘its not what you say, it’s how you make me feel’. They also highlighted that it showed engagement from a local team who are continuing to challenge themselves and put themselves in their patients’ shoes.
All staff working in the unit participated in the Emotional Intelligence-based training as Butterfly Champions and this has been empowering for staff. They reported a great sense of achievement from the results of the project and the recognition through the award.
Malou Salay, leader of end stage of dementia at the unit, said, “This has been the most difficult and the most rewarding process”, while her colleague Ellen Badal, house leader of early stage of dementia, said she was very proud of the ward.
Staff nurse MT Marana said the achievements to do and the successes seen have made her feel challenged to do even better. CNM1 Bebe Lagman said she felt ‘very happy’ to be part of this great achievement. HCA Lorraine Verhoven reported that she felt ‘amazing’ after the win was announced.
Household Manager Garrett Gilbride added, “After all the hard work, fun and education we have gone through as a team it was rewarding and completely uplifting to receive this award. It makes me feel that it was worth every effort made by the team and has spurred us on to continue to maintain, if not improve on, the high standard of care we offer in our home,” he said.