Was This A Quality Experience For Mavis? 

Mavis was taken out of her own comfort zone where she feels comfortable has a routine and feels safe. Mavis had to travel on her own in the ambulance, however why was her neighbour not allowed to go in the ambulance with her as a familiar face, this caused Mavis to be scared and worried. It doesn’t seem that the paramedics reassured Mavis or even communicated with her. 

Lack of communication seems to be a major issue for Mavis, it is not clear if anybody explained to Mavis what was going on or who people were. People are communicating around her but nobody seems to inform her what is happening or what she needs to do. 

As soon as someone communicates with Mavis and has a smile on their face and explains what Is happening, it allows Mavis to feel more comfortable and provides the reassurance she needs as Bill is not around. As the practitioner was approachable Mavis felt less scared. 

Why did they not wait for Bill to be with Mavis during the X-ray. Mavis is in an unknown environment and keeps asking for Bill. If they waited for Bill to arrive this may have allowed Mavis to feel more comfortable and understand what is going on. 

The lack of communication within the case study is the key issue that effected the quality of care Mavis received. 

Nicky Adams & Katie Hutton. 

·         Patience 

·         Listening skills 

·         Utilising a calm approach 

·         Communication- communicating sensitively 

·         Recognising the signs of distress because of confusion.

·         Promoting independence 

·         Patient/carer and staff feedback 

Using the PDSA cycle 

·         Utilising dementia suites where possible for patients who are admitted into hospital to promote a calming environment.  They have been proven beneficial within local trusts to help calm dementia patients due to having a homely setting with often familiar surroundings. 

·         Who-  We would gather patient, carer and staff feedback so we know that there is a problem in dementia care and this need improving. 

·         What- We would measure the incidence of distress within patients with dementia coming into the emergency setting and then compare it against when they were moved to a dementia suite and staff communicates using certain skills to see if this does calm the patient down. 

·         Where- within the emergency setting 

·         When- on first admission of patients. 

 Do- Leading the team

·         Utilising a multi-disciplinary team to work together to promote a dementia friendly environment for patients incorporating Care facilitators- Nurses, health care assistants, dementia specialised nurses and dementia support workers. 

·         Documenting the effect of staff skills and if patients are calmer in the dementia suites 

·         As more patients come in with dementia we would run out of space for putting people in dementia suites however we can overcome this barrier by setting out some assessment criteria for the stage of dementia a patient has as to which patients have priority. 

·         Would we be able to offer enough support for patients with dementia due to staff shortages and lack of training within staff? We can overcome this barrier by providing training for staff already working on the wards they have an understanding and knowledge of how to deal with dementia patients. 
Study-  

·         when the plan is implemented we would look at the data and see what needs to be acted on

·         We will compare the predictions we had for our initial plan against the data we collect to see if any of the changes would be beneficial. 
 Act-  

·         The changes that need to be made such as offering more training to staff in emergency settings to understand and recognise signs or patients with dementia who need extra support. 

·         Incorporating the use of dementia suites more often.