HSE launches 2nd National Audit of Dementia Care in Acute Hospitals

Press Release: Tuesday Sept 1st 2020

 

The HSE National Dementia Office have today, Tuesday 1st September 2020, launched the 2nd  National Audit of Dementia Care in Acute Hospitals (INAD-2).

The results of the 2nd audit show that many areas of general care, such as the management of pressure ulcers and nutrition assessment, have improved since the original audit was reported in  2014.

There were also improvements in staff training in dementia care. Approximately 1/3 of hospitals now have dementia-specific staff employed, and the same proportion have a dementia quality improvement team or working group, reflecting a desire to work together within the hospital improve dementia care.

The audit identified that improvements are needed in the gathering and recording of information to support person-centred care and in screening for delirium on admission to hospital. 

The audit took place in 33 acute hospitals. Two large orthopaedic hospitals were also included in this round, recognising the overlap between hip fracture and dementia.

The Audit examined 9 areas;

  1. Governance and Dementia Specific Roles
  2. Availability of Services
  3. Physical Ward Environment
  4. Physical Assessment
  5. Mental Assessment
  6. Staff Training
  7. Discharge Planning and Discharge
  8. Palliative Care
  9. Psychotropic Prescribing

Speaking about the audit results, Dr Suzanne Timmons, Clinical Lead for the National Dementia Office, welcomed the improvements on the 2014 audit: “I want to thank the hospitals for taking part in the audit and for their commitment to improving the hospital experience of people living with dementia.  This audit is extremely important in helping us to improve the care of people living with dementia in acute hospitals. Approximately 1 in 3 patients aged 70 and older admitted to Irish hospitals have dementia and this figure will increase annually as the population ages. This audit shows promising improvements in the presence of dementia quality improvement teams and staff with a specific dementia role in many hospitals. There was also evidence of physical environment changes that would enhance the experience and safety of a person living with dementia. There are other areas like recording the type and severity of dementia, and gathering information to support person-centred care that need further work at national and local level to support improved practice.” 

Dr. Vida Hamilton, the National Clinical Advisor & Group Lead for Acute Operations in the HSE said: “The audit results show that good progress has been made in making hospitals more “dementia friendly”, and the improvements in the performance of key assessments, like checking nutritional status and mobility, is welcome. We now need to focus particularly on delirium screening, assessment and treatment, for people living with dementia and other vulnerable patients in our acute hospitals. Delirium increases the risk of death and discharge to residential care, so its prompt diagnosis and treatment is vital. Staff training and the implementation of national dementia pathways are the foundation of improved dementia care. This year has brought additional challenges for our acute hospitals with the COVID-19 pandemic, but our staff remain committed to excellent care for all our patients, including people living with dementia.”

Kevin Quaid, Acting Chair of the Irish Dementia Working Group said: “As a person living with Lewy body Dementia, any admission to an acute hospital leaves me vulnerable to a worsening of my dementia and quality of life. I have experienced first-hand the difference a Dementia Nurse Specialist makes to the care of a patient with dementia in hospital. I urge the government to implement the National Clinical Guideline on Psychotropic Medications in all settings, including in acute hospitals, and the HSE to facilitate training for hospital staff so that they can keep a person living with dementia as independent and safe as possible during their hospital stay”.

Máire Anne Doyle, a member of the Dementia Carers Campaign Network, added: “As a carer for my father who is living with vascular dementia, I have seen how hospital staff who have received dementia training can communicate well with a person living with dementia, and provide person-centred care. Recognising the role of the carer and their natural concern for the person living with dementia in a new environment is also important.  I would strongly support the recommendation that acute hospital staff undergo dementia awareness training and formal dementia education, as outlined in the INAD-2 report.”

The National Dementia Office has produced a range of online resources to support acute hospital staff and will meet with each Hospital Group to discuss their group’s findings and their action plans for improved acute hospital dementia care in 2021/2022.

 

Last updated on: 01 / 09 / 2020