Volunteers improving person-centred dementia and delirium care in a rural Australian hospital.
BACKGROUND
The aim of the present study was to address the challenges faced by staff in an acute rural hospital in Australia when providing person-centred care for patients with dementia and/or delirium. This was done by training volunteers to provide personal support to these patients, then measuring the outcomes of this intervention.


METHODS
Volunteers were given training, then allocated patients with dementia/delirium or at risk of delirium. A quasi-experimental pre-post design assessed outcomes of the intervention. Quantitative measures were clinical outcome data for the 64 patients who passed through the program; questionnaire data related to the stress and attitudes of the 18 participating nurses; and attitudes, knowledge and confidence of the 18 volunteers. Qualitative measures assessed acceptability and feasibility of the intervention to staff and volunteers.


RESULTS
There was a significant reduction over time in length of stay for patients, and an increase in the use of analgesic medications. Only one patient fell while volunteers were on duty. There were no effects on the stress of nursing staff or their attitudes to dementia. Volunteers gained significantly in confidence and attitudes to dementia. The program was highly acceptable, with 96% of staff and 100% of volunteers perceiving the program as beneficial for patients, staff and volunteers. The program has continued and is now being expanded to other rural sites.


CONCLUSIONS
It is feasible to introduce and then sustain a relatively inexpensive program to improve quality of care for people with dementia and/or delirium in an acute rural hospital. Reasons for the program's effectiveness are canvassed in the paper, but further research is needed to investigate the effectiveness of a similar program in urban hospitals.
Southern New South Wales Local Health District, Queanbeyan, New South Wales, Australia. cath.bateman@gsahs.health.nsw.gov.au.
Catherine
C
Bateman
Southern New South Wales Local Health District, Aged Care Evaluation Unit, Queanbeyan, New South Wales, Australia. katrina.anderson@gsahs.health.nsw.gov.au.
Katrina
K
Anderson
Southern New South Wales Local Health District, Aged Care Evaluation Unit, Queanbeyan, New South Wales, Australia. michael.bird991@binternet.com.
Michael
M
Bird
Faculty of Health, University of Canberra, Canberra, Australia. chungerford@csu.edu.au.
Catherine
C
Hungerford
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003693:Delirium / Q000628:therapy*; D003704:Dementia / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006780:Hospitals, Rural / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D018802:Patient-Centered Care / Q000458:organization & administration*; D013315:Stress, Psychological / Q000453:epidemiology; D014838:Volunteers
Aged Care; Allied Health; Australia/Pacific; Consumer perspectives; Evidence-based Care; Geriatrics; Medical; Nursing; Pain Management; Palliative Care; Psychology; Qualitative Research