"Dementia-friendly hospitals: care not crisis": an educational program designed to improve the care of the hospitalized patient with dementia.
BACKGROUND
Approximately 3.2 million hospital stays annually involve a person with dementia, leading to higher costs, longer lengths of stay, and poorer outcomes. Older adults with dementia are vulnerable when hospitals are unable to meet their special needs.


METHODS
We developed, implemented, and evaluated a training program for 540 individuals at 4 community hospitals. Pretest, posttest, and a 120-day delayed posttest were performed to assess knowledge, confidence, and practice parameters.


RESULTS
The mean age of the sample was 46 years; 83% were White, 90% were female, and 60% were nurses. Upon completion, there were significant gains (P's <0.001) in knowledge and confidence in recognizing, assessing, and managing dementia. Attendees reported gains in communication skills and strategies to improve the hospital environment, patient safety, and behavioral management. At 120 days, 3 of 4 hospitals demonstrated maintenance of confidence. In the hospital that demonstrated lower knowledge and confidence scores, the sample was older and had more nurses and more years in practice.


CONCLUSIONS
We demonstrate the feasibility of training hospital staff about dementia and its impact on patient outcomes. At baseline, there was low knowledge and confidence in the ability to care for dementia patients. Training had an immediate impact on knowledge, confidence, and attitudes with lasting impact in 3 of 4 hospitals. We identified targets for intervention and the need for ongoing training and administrative reinforcement to sustain behavioral change. Community resources, such as local chapters of the Alzheimer Association, may be key community partners in improving care outcomes for hospitalized persons with dementia.
Galvin
James E
JE
*Alzheimer Disease Research Center †Departments of Neurology ‡Psychiatry §Neurobiology, Washington University School of Medicine ∥Alzheimer Association, St Louis Chapter, St Louis, MO.
Kuntemeier
Barbara
B
Al-Hammadi
Noor
N
Germino
Jessica
J
Murphy-White
Maggie
M
McGillick
Janis
J
D000368:Aged; D001291:Attitude of Health Personnel; D003479:Curriculum; D003704:Dementia / Q000628:therapy*; D004502:Education, Medical, Continuing / Q000379:methods; D005260:Female; D006761:Hospitals / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000193:education; D010043:Outcome and Process Assessment, Health Care; D010564:Personnel, Hospital / Q000193:education*; D015397:Program Evaluation; D058996:Quality Improvement