Implementation of a training program to increase knowledge, improve attitudes and reduce nursing care omissions towards patients with dementia in hospital settings: a mixed-method study protocol

Comparison of face to face and online delivery of a dementia-specific experiential learning activity

During the COVID-19 pandemic, healthcare professions shifted from face to face(F2F) to online educational delivery methods. Research evaluating the effectiveness of online educational delivery is mixed.The purpose of this study was to compare the effectiveness of a dementia-specific experiential learning activity(ELA) delivered to Doctor of Physical Therapy(DPT) students face to face(F2F) versus online. Participants included a sample of DPT students (n = 171) from four consecutive cohorts. In this quasi-experimental, single-site two-factor design study, students participated in either a F2F(n = 84) or online version (n = 87) of an ELA. They completed a dementia survey pre-(T1) and post-ELA(T2). Pre- and post-survey analysis demonstrated significant improvements between T1 and T2 for both groups. The interaction of group by time F(1,169) = 287.61, p < 0.01 indicates a main effect for groups over time. Analysis did not demonstrate significance between versions for T1 or T2. The interaction of time by group F(1,169) = 1.08, p = 0.30 indicates there was not an interaction of time by group.This study provided strong evidence that students benefitted from the dementia-specific ELA regardless of delivery method. Both methods proved equally effective, as there was no statistically significant difference between them. Programs may consider online experiences to increase schedule flexibility and content accessibility.

Impact of a short-duration experiential learning activity on DPT students' attitudes toward patients living with a dementia

Healthcare practitioners (HCP) have expressed inadequate preparation in providing care to patients living with a dementia. Research suggests experiential learning activities (ELAs) can improve HCP knowledge and comfort toward this population. The purpose of this study was to evaluate the impact of a short-duration (2-hour) dementia ELA on Doctor of Physical Therapy (DPT) students' knowledge and comfort toward individuals living with a dementia. Participants included a sample of first-year DPT students (n=82).  In this pre-experimental, single-site, longitudinal study, students participated in an ELA at a memory care facility. They completed a dementia knowledge and comfort survey pre-(T1) and post-ELA(T2), as well as prior to their first clinical experience (nine months post-ELA; T3). Pre- and post-survey analysis demonstrated significant improvements between T1 to T2 and T1 to T3 with overall effect sizes ranging from very large (d=1.256) to huge (d=1.520). There were no significant differences between T2 to T3 analysis. Students demonstrated positive improvements in attitudes toward individuals living with a dementia following this ELA. Improvements were maintained over time. An ELA as short as two hours may improve person-centered care for patients living with a dementia. These types of activities should be considered for inclusion in DPT curricula.

Identifying undergraduate nurses´ learning requirements and teaching strategies in dementia care education: A nominal group technique

AIM

Identify priorities and reach a consensus on student nurses´ learning requirements and the best-suited teaching strategies in dementia care.

BACKGROUND

Dementia has become a global health priority. Nurses are primary service providers for people with dementia, but they may fall short on professional training. Nursing curricula still lacks a clear educational framework for dementia, meaning that nurse educators must make decisions amidst uncertainty.

DESIGN

Nominal group technique based on the conceptual framework proposed by Van de Ven and Delbecq (1972).

METHODS

A structured face-to-face meeting convened in November 2021 involved nine participants who were directly involved in dementia care. The steps in the technique were (a) idea generation, (b) round-robin recording, (c) discussion, (d) voting and ranking, (e) discussion on the vote and (f) re-ranking. Participants answered two nominal questions. Consent, anonymity, feedback and iteration were guaranteed throughout the process.

RESULTS

The nominal group prioritized theoretical understanding of dementia, communication, caregivers´ needs, comprehensive assessment and ethical practice as learning requirements for nursing students. The outstanding teaching strategy discussed included various approaches to experiential learning.

CONCLUSIONS

The nominal group technique process explored learning requirement priorities for student nurses within a specific context. Participants discussed experiential learning as the best-suited teaching strategy. Findings could support nurse educators to design and deliver better dementia education.

Exploring nursing students' knowledge of Alzheimer's disease

BACKGROUND

As the number of people with a diagnosis of dementia continues to increase, it is essential that nurses have the skills required to provide high-quality care. However, there may be gaps in dementia teaching in undergraduate nurse education programmes in the UK.

AIM

To assess knowledge of Alzheimer's disease among one cohort of third-year nursing students to improve the education content of the dementia module at Oxford Brookes University, England.

METHOD

A total of 35 participants completed the Alzheimer's Disease Knowledge Scale, a validated tool that measures knowledge about risk factors, assessment and diagnosis, symptoms, course (disease progression), life impact, caregiving, and treatment and management. Data were analysed using quantitative methods.

RESULTS

Participating students appeared to have greater knowledge about dementia in relation to treatment and management, life impact, caregiving, and assessment and diagnosis, and less knowledge about risk factors, course and symptoms. This may be because the focus of teaching is on caregiving and medical treatment.

CONCLUSION

This study identified strengths and gaps in nursing students' knowledge of Alzheimer's disease. The results have informed recommendations for ways to improve the education content of the dementia module for future cohorts and to enhance dementia education in nursing, health and social care undergraduate programmes in general.

Role of Dutch internal policy advisors in a hospital quality improvement programme and their influence on nurses' role development: a qualitative study

OBJECTIVE

Nurses are vital in providing and improving quality of care. To enhance the quality improvement (QI) competencies of nurses, hospitals in the Netherlands run developmental programmes generally led by internal policy advisors (IPAs). In this study, we identify the roles IPAs play during these programmes to enhance the development of nurses' QI competencies and studied how these roles influenced nurses and management.

DESIGN

An exploratory ethnographical study comprising observations, informal conversations, semistructured interviews, focus groups and a strategy evaluation meeting.

SETTING

A teaching hospital in an urban region in the Netherlands.

PARTICIPANTS

IPAs (n=7) in collaboration with four teams of nurses (n=131), team managers (n=4), senior managers (n=4) and the hospital director (n=1).

RESULTS

We identified five distinct advisory roles that IPAs perform in the hospital programme: gatekeeper, connector, converter, reflector and implementer. In describing these roles, we provide insights into how IPAs help nurses to develop QI competencies. The IPA's professional background was a driving force for nurses' QI role development. However, QI development was threatened if IPAs lost sight of different stakeholders' interests and consequently lost their credibility. QI role development among nurses was also threatened if the IPA took on all responsibility instead of delegating it timely to managers and nurses.

CONCLUSIONS

We have shown how IPAs' professional background and advisory knowledge connect organisational, managerial and professional aims and interests to enhance professionalisation of nurses.

Missed Nursing Care Among Patients With Dementia During Hospitalization: An Observation Study

Patients with dementia (PwD) are characterized as a vulnerable group as they are unable to communicate their needs, putting them at risk for care omissions. The current study aimed to explore care toward PwD and detect if any aspects of care are omitted. An observation study was conducted in three medical-surgical adult wards of an acute general hospital. Data were collected by an observer, through field notes, and were analyzed with content analysis. A face scale was used to assess PwD's mood. Thirteen PwD were observed for 90 hours. Four thematic areas were identified: (a) Unmet Fundamental Patient Needs, (b) Human Right to Dignity and Respect, (c) Communication Deficiencies, and (d) Implementation of Nursing Interventions. Nurse-patient contact lasted from 5 to 7 minutes and numerous care omissions were noted. The face scale assessment revealed that most PwD looked very sad after nursing care. This study enriches insight for the care of PwD during hospitalization and emphasizes the need for health care workers' education and support. [Research in Gerontological Nursing, 14(3), 150-159.].

National policy actions on dementia in the Americas and Asia-Pacific: Consensus and challenges

Alzheimer's disease and related dementias (ADRD) affect over 50 million persons globally, and the number is expected to rise. In response, health ministries are developing and implementing policies and programs to systemically address the needs of individuals and families affected by ADRD. While national plans of action on ADRD are advancing among European Member States of World Health Organization (WHO), those in the Asia-Pacific and Americas are lagging behind. Since previous studies have largely ignored the Americas and Asia-Pacific-where approximately two-thirds of the global ADRD population resides-this study sought to identify (a) the socioeconomic factors associated with the likelihood of having a national dementia policy, and (b) to examine common and differing features among the national plans in these regions. Employing the dementia policy guidelines of WHO and the Pan American Health Organization as an extraction guide for data collection and analysis, the national dementia plans and available socioeconomic data of 10 Member States were analyzed with comparative and qualitative analyses. Findings suggested at least a 14-fold increase in the likelihood of having a national dementia plan if a Member State had one of the following: a universal health care system, more than 14% of the population 65 years of age or older, or high-income. All the Member States in the study identified dementia as a public health priority, but priorities differed. Inconsistencies included development of information systems, training for health care professionals, and long-term care systems.