The Management of Dementia Patients in Acute Care - Case Study Example

Best Practice for the Management of Dementia Patients in the Acute Care Setting Name: Grade Course: Tutor’s Name: Introduction Why would one want to manage dementia patients in an acute care setting? Just like in all other health care settings, the main aim of providing health care is to improve the quality of life and improvement of quality of life requires identification of the factors that affect the quality of life. These factors have to be assessed and methods of avoiding if in incase they have negative effects, controlling and managing them developed. This requires management and so it is the reason why it is very important to manage patients with dementia. A best practice is an activity, a method, a reward, a process, or an incentive that is considered to be more effective in delivering a particular result. In management, there are best practices and these depend on the aims of the management group or team. In the above case for example, the aim of the management department of team would be to ensure quality life in dementia patients in the acute care setting. Practices, activities, processes, methods and so on, aimed at effectively improving or ensuring quality life in dementia patients in acute settings therefore will be considered best practices. Effectiveness of an activity, process, method or any practice also depends on the aim of using such a method, process, activity or process. This paper is about best practices in the management of dementia patients in acute care settings. It will cover what some authors consider best practice in relation to the findings they have got about dementia patients and provision of health care to such patients. Information about best practice will be obtained from their recommendations, results and discussions. Best Practice for the Management of Dementia Patients in the Acute Care Setting Park and other researchers work is all about a standardized form of caring for the old aged patients with dementia. According to Park and others, there is no specific approach used by nurses for caring for patients with dementia yet their problems are well recognized. The study showed that the co morbidities related to dementia in old people are known, the characteristics of patients suffering from dementia are known and there are nursing interventions to the dementia patients as well as diagnosis. Very little clinical data is however available showing the nursing interventions, the nursing diagnoses and the nursing outcomes. With the availability of such information, a specific standardized approach of caring for dementia patients in acute care can be developed (Park et al, 2004). Park and the other researchers recommended that how nurses diagnose dementia patients, the interventions they use and the outcomes of the interventions as well as the diagnoses should be documented in a standardized manner to support the concept of computerized patient record hence help in the management of dementia patients in acute care (Park et al, 2004). The aim of the research study was to describe the characteristics of dementia patients that were hospitalized, the characteristics of the diagnoses and interventions used by nurses and to determine the nursing care trends in USA using a Nursing Minimum Data Set. One community hospital was used for the study. The results gave the researchers proof that there is no specific approach taken by nurses in caring for such patients and that very little clinical data was available on how these patients should be diagnosed, treated and cared for (Park et al, 2004). One best practice proposed by this research study is the development of standardized methods that can be adopted by acute health care settings for such patients. Under the characteristics of the nursing care, the results showed that the number of patients discharged with home health service decreased over three years, the number of those discharged without service increased and those discharged to skilled nursing homes increased. This according to result analysis showed that no standard practice has been developed for the care of dementia patients in acute care settings therefore the recommendations provided (Park et al, 2004). As indicated above, best practices are those that aim at producing effective results depending on the aim of whoever is after the outcomes. In management of dementia patients, there are a lot that need to be considered for example, how patient satisfaction can be achieved. Based on what information managers have on dementia patients, how they should be treated and what methods are effective in treating such patients, the managers should be able to identify best practices and implement. O’Connell and others for example indicates that based on increasing population of the elderly and the increasing number of people diagnosed with dementia, nurses are expected to provide effective interventions to safely manage those diagnosed with dementia (2007). Park and others above indicate that there is little known about the interventions and if they are known, then little is known about how effective they are (2004). This is confirmed by O’Connell and others’ research study although they propose the use of RO. From a review of research studies about RO, O’Connell and other researchers found out that reality orientation has the potential to improve dementia patients’ care in acute care settings (2007). The efficacy and feasibility of RO has however not been examined sufficiently (O’Connell et al, 2007), but if such an approach can be found effective, it can be developed by acute care settings for dementia patients as best practice. Its efficacy has to be compared with others with the same function. In Todd & Todda (2010) and Sabbagh and other researchers’ (2003) work, it is indicated that dementia is associated with increased length of stay in skilled nursing facilities. Best management practices for dementia patients should therefore focus on finding out ways of dealing with dementia patients to ensure quality care. Whether the management allows longer stay or not all depends on what they find appropriate for the patients and the most important factor to be considered in this case in the patients’ life and health. If letting the patients stay longer in the skilled nursing facilities can help the management achieve its objectives then, such an approach should be adopted. Information from resources however views longer stay in skilled nursing facilities as expensive and non effective. Sabbagh and others for example proposes that management of dementia patients should consider using various levels of skilled nursing facilities to deal with the issue of increased length of stay in such facilities (2003). There is however little information about the use of different levels of skilled nursing facilities, the effectiveness of the use of such levels and the impact of SNF care on the length of stay on dementia patients. One problem has been identified in this case and according to Sabbagh and his colleagues it is not possible to care for dementia patients after admission till death unless full time skilled medical care can be provided. Best practice aims at achieving the best results (2003). If skilled medical care is all that it takes to provide quality life to dementia patients, then an appropriate way of providing such care should be developed. This does not mean that the patients have to stay longer in skilled nursing facilities. The management can find out how these patients can receive the same skilled medical care in their communities. Management is also about identification of changes and managing them appropriately and good management of resources. Changes in any organization affect its success as well as the available resources. Managing dementia patients would require human resources that would ensure they are treated accordingly and receive quality care. An example of an important resource is the skilled nurse. Best practice should ensure the human resource is well managed so that the activities achieve the organizational aims. Take an example of ensuring that all dementia patients receive skilled nursing care at home after discharge. Allocation of appropriate resources that would ensure such services reach dementia patients will be considered best practice. Management of change is also important like (Todd & Todda (2010) highlight. Todd and Todda indicate that even in the management of dementia patients in acute hospital, there are cases that are different and so should be well managed. An example is the case of a dementia patient who is not able to cope at home alone because of the progress he/she is making in coping with dementia (2010). Such patients should not be admitted in the acute hospital. Instead, their post care should be well coordinated considering services offered by the general practitioners, the family and the skilled nursing facility (Todd & Todda, 2010). The hospital design for dementia patients should also be dementia friendly, the staff handling dementia patients should be trained and good management practices developed to ensure each patient is treated according to his or her condition. Dementia has so many comorbidities and different patients suffer from different comorbidities. For this reason, it is important to classify each patient based on disease severity, complications or other important characteristics that can help diagnose and treat the patients effectively (Todd & Todda, 2010). Conclusion An important best practice that has been identified is standardization of diagnostic processes used in diagnosis of dementia patients and intervention processes used by nurses. This will help health care providers with the continuity of care for dementia patients. With standardized treatment processes, activities or nursing care, any patient can receive continued care in any health care setting for dementia patients provided the medical records for the patients are available. Best practices are not specific but all depends on what the organization aims to achieve. One aim however is mandatory in health care institutions. This is to improve the quality of life. In order to improve quality of life, the factors that affect quality of life have to be identified then ways of managing them developed. In the above case, organizational management is an issue, resource management is also an issue and identification of patient requirements is also an issue. By developing processes and activities that ensure effective management of change and resources and patient needs, best practices are developed. References O’Connell, B., Gardner, A., Takase, M., Hawkins, M. T., Ostaszkiewicz, J., Ski, C. and Josipovic, P., 2007, Clinical Usefulness and Feasibility of Using Reality Orientation with Patients Who Have Dementia In Acute Care Settings. International Journal of Nursing Practice, 13, pp. 182-192. Park, M., Delaney, C., Maas, M. and Reed, D., 2004, Using a Nursing Minimum Data Set with Older Patients With Dementia In An Acute Care Setting. Journal of Advanced Nursing, 47 (3), 329-339. Sabbagh, M. N., Silverberg, N., Majeed, B., Samant, S., Sparks, D. L., Seward, J. and Connor, D. J., 2003, Length of Stay In Skilled Nursing Facilities Is Longer For Patients With Dementia. Journal of Alzheimer’s Disease , 5, pp.57-63. Todd, D. L. and Todda J., 2010, Dementia Care in the Acute District General Hospital. Clinical Medicine, 10(3), Pp.220-222. Read More