168 A quality improvement initiative to enhance dementia inclusivity within the physical environment of an older persons’ acute hospital ward

Abstract

Abstract Background There are currently over 64,000 people living with dementia in Ireland, this number is expected to double by 2045. Direct observation from multiple disciplines highlighted a large cohort of people living with dementia experiencing disorientation, wandering, and falls at ward level. National Guidelines and Strategies state that physical ward environments should be a key consideration for dementia care. Research shows that physical ward environments can be adapted to reduce confusion and agitation and improve wayfinding for those living with dementia. Methods An environmental ward audit was conducted through direct observation, using the environmental checklist from the Irish National Audit of Dementia (INAD-2). The results of the audit were compared with national standards which showed reduced compliance. Adaptations and/or modifications including the installation of orientation clocks, orientation whiteboards and increasing signage and labels to the physical ward were implemented to increase compliance. The ward was re-audited to assess change. Results The results highlighted increased compliance with national standards. Direct observations from the multidisciplinary team identified increased wayfinding and orientation for patients living with dementia on the ward. Multidisciplinary education on dementia inclusivity is essential in fostering a person centred approach to dementia care in the acute ward environment. Conclusion Multidisciplinary collaboration and commitment to dementia inclusive care may enhance the experience of those living with dementia in the acute hospital setting. Barriers such as infection control measures emphasised the need for a collaborative approach to overcome challenges and facilitate change.