Improving Management of Behavioral and Psychological Symptoms of Dementia in Acute Care: Evidence and Lessons Learned From Across the Care Spectrum

As the prevalence of Alzheimer disease and related dementias increases, dementia-related behavioral symptoms present growing threats to care quality and safety of older adults across care settings. Behavioral and psychological symptoms of dementia (BPSD) such as agitation, aggression, and resistance to care occur in nearly all individuals over the course of their illness. In inpatient care settings, if not appropriately treated, BPSD can result in care complications, increased length of stay, dissatisfaction with care, and caregiver stress and injury. Although evidence-based, nonpharmacological approaches to treating BPSD exist, their implementation into acute care has been thwarted by limited nursing staff expertise in behavioral health, and a lack of consistent approaches to integrate behavioral health expertise into medically focused inpatient care settings. This article describes the core components of one evidence-based approach to integrating behavioral health expertise into dementia care. This approach, called STAR-VA, was implemented in Veterans' Health Administration community living centers (nursing homes). It has demonstrated effectiveness in reducing the severity and frequency of BPSD, while improving staff knowledge and skills in caring for people with dementia. The potential for adapting this approach in acute care settings is discussed, along with key lessons learned regarding opportunities for nursing leadership to ensure consistent implementation and sustainability.

Student life - How to practise effectively

Referring to the Nursing and Midwifery Council Code's second theme - practise effectively; think what effective nursing care means to you and how this has an impact on the essence of quality care.

Early Identification of Acute Hemolytic Transfusion Reactions: Realistic Implications for Best Practice in Patient Monitoring

Acute hemolytic transfusion reactions can result in severe complications and death. Through early identification and prompt intervention, nurses can reduce the risks associated with these serious reactions. Realistic evidence-based patient monitoring protocols can help guide identification of acute hemolytic transfusion reactions and facilitate lifesaving interventions to avert critical patient situations.

Antithyroid Drugs for Hyperthyroidism

Hyperthyroidism is a treatable endocrine disorder. Having a working knowledge of the current evidence-based guidelines for treating hyperthyroidism aids in improved patient care.

Implementation of an Evidence-Based Patient Safety Team to Prevent Falls in Inpatient Medical Units

Falls are a patient safety priority among hospital inpatients. The creation of a Patient Safety Team engaged frontline staff in patient safety and falls prevention. This intervention decreased the fall rate from 1.90 to 0.69 falls per 1,000 occupied bed days.

Developing Evidence-Based Care Standards and a Decision-Making Support System for Pain Management

Pain is a crucial sign and symptom in hospitalised patients. This paper describes how a medical centre created a knowledge-based, computerised pain management decision-making process to support nurses in personalising preventive interventions based on patient requirements.

Development of an Open Source Educational Resource: "Clinical Procedures for Safer Patient Care"

An Open Education Resource (OER) has been developed by two nurse educators to address inconsistencies in how clinical health care skills are taught and practiced in the clinical setting, and to ensure best practice and quality care based on the latest evidence. A checklist approach aims to provide clear steps and rationale for procedures, standardized processes for clinical skills and to assist nursing schools and clinical practice partners in teaching clinical skills, and keeping procedural practice current. The format is logical, organized and focused on patient safety, and will provide information retrieval opportunities at the point of care to support decisions and plan patient care. This poster discusses the development of this resource, the framework used, and the process from conception to distribution.

Postnatal Depression: Don't reinvent the wheel

Poor mental health accounts for 23% of all ill health in the UK, with the cost of treating it expected to double in the next 20 years. In addition, postnatal depression (PND) in both mothers and fathers can have a detrimental long-term impact on a child's cognitive, social and behavioural development. This paper discusses the development process of an innovative evidence-based resource which involved professional expertise and parent involvement. This unique resource helps to recognise PND in both mothers and fathers and will support health visitors in making a real impact in improving outcomes for children and families.

Aging population

Our aging population is rapidly growing and accounts for 46% of critical care patients and 60% of medical-surgical patients in the hospital. These acutely ill patients are challenging to frontline nurses because they frequently have multiple chronic conditions. This article provides a tool kit of resources and clinical skills to develop safe, quality, and accountable care plans for positive patient outcomes; it presents several resources to assist in individualized care, the complexity of care, and the issues of transitions of care. This article empowers frontline nurses to develop gerontological skills and meet the unique needs of our aging population.

Preventing Progression of Post-Thrombotic Syndrome for Patients Post-Deep Vein Thrombosis

Post-thrombotic syndrome is a chronic condition that develops in up to 50% of patients with acute deep vein thrombosis. Its burden includes increased costs, decreased quality of life, and decreased personal productivity.