Prevention and management of behavioural and psychological symptoms in patients with dementia in acute care: a best practice implementation project. Issue 4 (14th December 2022)

• Record Type: Journal Article
• Authors: Akrour, Rachid; Courret-Gilgen, Catherine; Perrenoud, Beatrice
• Is Part Of: JBI evidence implementation. Volume 20:Issue 4(2022)
• Page Start: 289
• Page End: 300
• Publication Date: 2022-12-14
• Subjects: acute care -- behavioural and psychological symptoms of dementia -- dementia -- nonpharmacological intervention -- older adults; Evidence-based medicine -- Periodicals; Evidence-Based Medicine; Implementation Science; Evidence-based medicine; Periodical; Periodicals; 616.005
• DOI: 10.1097/XEB.0000000000000329
• Languages: English
• ISSNs: 2691-3321

Abstract

ABSTRACT: Introduction: Behavioural and psychological symptoms of dementia are very common in acute care. Agitation and aggressive behaviours are the most common symptoms and are challenging to manage. Early detection and a nonpharmacological approach are recommended. Objectives: To implement evidence-based recommendations for the prevention and management of aggression/agitation in patients with dementia in an acute geriatric care unit. Methods: The project used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool. A baseline audit was conducted with seven audit criteria based on evidence summaries. It was followed by the implementation of an action plan and a follow-up audit. Results: Results showed moderate improvements in compliance with best practice recommendations. The second audit indicated an improvement up to 46% with the identification of factors/triggers that precipitate aggression/agitation and completion of a risk assessment. The highest improvement was the training of the nursing team (79%). Compliance with the involvement of patients and their families in the care planning improved slightly (14%). The lowest improvement was for the development and implementation of individualized care plans (10%). Conclusion: The project implementation achieved some positive changes. A formalized process for preventing aggression/agitation is in place. The interprofessional collaboration, the support given to the nursing team and the basket of nonpharmacological interventions were strengthened. The electronic documentation and a limited collaboration of the nursing team were challenging. As further strategies were implemented, further audit would be required to assess achievement in change and/or demonstration of improved care provided for this vulnerable population.