Background
As the world is shifting towards ageing population, diagnosis of dementia and cognitive impairment is one major factor that has increased hospital admission rate. However, the current issue is that health care staffs are not equipped with all skills to provide optimal care to people with dementia. Research evidence has highlighted gaps in the quality of care provided to people with dementia. Houghton et al. (2016) gave the evidence that dementia care is associated with many unique challenges for health care staffs and these issues have not been clarified yet. Lack of experienced nurse in dementia care and lack of organization of care in hospital are also some of the challenges in delivery of dementia care in elderly people (Gilster, Boltz & Dalessandro, 2018). Hence, unless these challenges are identified, the health care workforces cannot deal with high burden of dementia and issues related to dissatisfaction with care and poor patient outcome is going to increase. Education and training of staff is regarded as a solution to address the research problem. The main purpose of the research proposal is to identify the effectiveness of staff training in dementia care and evaluates changes in patient’s outcome after staff training.
Past research literature has highlighted about the dementia care related challenges and the potential of staff training in dementia care to improve outcome of elderly people. A review of gaps and challenges in the research can give an idea regarding what problems are encountered during staff training and how this proposal can address the issue. Fukuda, Shimizu and Seto (2015) gave idea about the challenges faced by dementia patient in nurses in providing care to dementia patients in acute care hospitals. By the use of a questionnaire based research design, the study revealed that problematic behaviour of patient jeopardize patient safety and lack of nursing experience regarding dementia care and lack of cooperation among health care professionals exacerbate challenges for nurses. However, the gap found in the research was that data was not collected from large hospitals and the findings obtained may not reflect the same situation for all hospitals. In addition, data was collected based on recollection leading to recall bias. Hence, direct observation was needed to analysed real practice challenges in clinical environment. Despite this limitation, systematic review of research also acknowledge the fact that caring for people with dementia is a complex process and understanding experience of staffs is needed to gain understanding regarding potential gaps in current skills of health care staffs (Prorok, Horgan & Seitz, 2013). Therefore, in response to the gaps found in the delivery of dementia care in health care setting, education and training of staffs is regarded as an appropriate solution to overcome all the challenges. This project proposal seeks to minimize the barrier associated with dementia care by providing training to
Aim and Objectives
The main aim of the proposal is to conduct a primary research study to identify the effectiveness of staff training and education in dementia care. The SMART objective of the proposal is as follows:
- To analysis deficits in dementia care related skills of health care staffs
- To observe limitations of gap in current skills related to dementia care
- To provide staff training related to dementia care
- To identify the impact of staff training on patient outcome
- To achieve 100% patient’s satisfaction with dementia care by six months period after the implementation of the training and education session.
To address the issue of challenges related to dementia care, many research work on staff training and education has been done in the past. Stevenson and Taylor (2018) explained that large number of people with dementia occupies hospital beds however lot of care quality concerns has been raised because lack of skills to provide effective dementia care. As limited attention has been paid to professional development needs of dementia care staff, a systematic review by Surr et al. (2017) gave an insight into the implications of training related to dementia care on patient outcome. Review of studies revealed that dementia care education was associated with positive staff outcomes such as satisfaction with the job and low level of stress. However, the study indicated that those training sessions would give positive outcome which focus on situated learning instead of discrete sessions with no links to real-world practice.
Another study specifically investigated about the impact of staff training programs for dealing with behavioural problems among older patient with dementia. The review of studies revealed that many types of training related interventions has been implemented for elderly people with dementia (McCabe, Davison & George, 2007). However, inconsistent result has been obtained because of poor research design. Staff training has been found to increase staff knowledge based and reduce behavioural problems in elderly people. However, lack of long term analysis and poor research design limited the reliability of research data. Another primary research study evaluated the efficacy of specialist dementia care training on attitudes and roles of efficacy of staffs caring for dementia people. The person centred training program was found to improve attitudes towards dementia care and increase their satisfaction level (Surr et al., 2016). However, convenience sampling strategy was a limitation which affected the transferability of research findings. Hence, past reviewed revealed many gaps in staff training program implemented for improving dementia care.
Research design: Based on the gap identified in research literature, it is necessary to first observe training needs of dementia care staffs and then plan training program accordingly. Hence, to gain knowledge related to the effectiveness of staff training on dementia care, it is planned to first conduct both survey and observation based studies. The first survey before the intervention will focus on identifying staff’s perspective regarding challenges in delivery of dementia care and things they require for support. At this point, observation by research staffs will also be done to identify any organizational or contextual barrier to care delivery. After this, patient-centred and real practice based dementia care training will be provided to staffs for two weeks and outcome related satisfaction with care delivery, patient outcome and attitude towards dementia care will be evaluated by a survey based questionnaire two months after the delivery of training. Validated questionnaire will be prepared that provides clear insight regarding the efficacy of the training program.
Literature review
Sample and setting: It is planned to conduct the research in large aged care setting where large number of people with dementia are admitted. The research will be done with dementia care nurses and approval for the research will be taken by the Human Research Ethics Committed. All participants will be recruited after giving information about the purpose of research and obtaining consent for research. Permission will be taken from the manager or head of the aged care setting regarding survey with staffs and observation of staffs and patients for a specific time period.
It is planned to complete the research within three months. The first two week will be for development of survey questionnaire, sample recruitment and survey related to challenges in dementia care. The next two weeks will be allotted to delivery of training program. The final survey will be completed after two months and full report with research outcome will be prepared by the next one month period.
It is expected that the research will help to identify real practice based barriers experienced by dementia care staffs and address those barriers of staffs by means of staff training. The research is also likely to improve staff’s confidence and attitude towards caring for people with dementia in aged care setting.
References:
Fukuda, R., Shimizu, Y., & Seto, N. (2015). Issues experienced while administering care to patients with dementia in acute care hospitals: A study based on focus group interviews. International Journal of Qualitative Studies on Health and Well-Being, 10, 10.3402/qhw.v10.25828. Doi: https://doi.org/10.3402/qhw.v10.25828
Gilster, S. D., Boltz, M., & Dalessandro, J. L. (2018). Long-Term Care Workforce Issues: Practice Principles for Quality Dementia Care. The Gerontologist, 58(suppl_1), S103-S113. doi:10.1093/geront/gnx174
Houghton, C., Murphy, K., Brooker, D., & Casey, D. (2016). Healthcare staffs’ experiences and perceptions of caring for people with dementia in the acute setting: Qualitative evidence synthesis. International Journal of Nursing Studies, 61, 104-116. Doi: https://doi.org/10.1016/j.ijnurstu.2016.06.001
McCabe, M. P., Davison, T. E., & George, K. (2007). Effectiveness of staff training programs for behavioral problems among older people with dementia. Aging and Mental Health, 11(5), 505-519. https://doi.org/10.1080/13607860601086405
Prorok, J. C., Horgan, S., & Seitz, D. P. (2013). Health care experiences of people with dementia and their caregivers: a meta-ethnographic analysis of qualitative studies. CMAJ?: Canadian Medical Association Journal, 185(14), E669–E680. https://doi.org/10.1503/cmaj.121795
Stevenson, M., & Taylor, B. J. (2018). Risk communication in dementia care: Family perspectives. Journal of Risk Research, 21(6), 692-709. https://doi.org/10.1080/13669877.2016.1235604
Surr, C. A., Gates, C., Irving, D., Oyebode, J., Smith, S. J., Parveen, S., … Dennison, A. (2017). Effective Dementia Education and Training for the Health and Social Care Workforce: A Systematic Review of the Literature. Review of Educational Research, 87(5), 966–1002. https://doi.org/10.3102/0034654317723305
Surr, C. A., Smith, S. J., Crossland, J., & Robins, J. (2016). Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study. International journal of nursing studies, 53, 144-151. Retrieved from: https://eprints.leedsbeckett.ac.uk/1756/3/Surr%252C%20Smith%252C%20Crossland%20and%20Robins%202015%20Final%20pre-print%20version.pdf
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