The CONNECT Study
Supporting person-centred care for people with dementia in hospital settings: co-designing and testing the feasibility of an intervention for use during constant observation activities.
Project duration
24 months (July 2021- June 2023)
Funder
Alzheimer's Society (grant number 516 AS-PG-19a-010)
Principal Investigator:
- Dr Melanie Handley (PI), University of Hertfordshire
Co-Investigators:
- Professor Claire Goodman, University of Hertfordshire
- Rosemary Phillips, University of Hertfordshire
- Professor Rowan Harwood, University of Nottingham, Nottingham University Hospitals NHS Trust
- Professor Clair Surr, Leeds Beckett University
Research fellows:
- Danai Theodosopoulou, University of Nottingham
- Dr Nicky Taylor, Leeds Beckett University
Institutions
- University of Hertfordshire
- University of Nottingham
- Leeds Beckett University
Stage of development
Phase 1 recruitment and data collection have been completed. The team are analysing the data and preparing papers from phase 1.
Recruitment is open for Phase 2, the co-design of an intervention.
What is the study about?
Despite widespread initiatives to improve dementia care in hospitals, applying person-centred care during routine patient/staff encounters continues to challenge hospital staff. One priority area for hospitals is to manage a person's risk of harm, for example from falls. A common strategy to manage people with dementia's risk of harm is constant observation; a care activity which involves the allocation of a member of staff to provide constant supervision and address the care needs of one patient or a small group of patients in one bay area. The quality of care during these activities varies.
Aims
The aim of this study is to co-design and evaluate the feasibility and acceptability of an intervention that promotes person-centred care for people with dementia during constant observation activities in acute hospitals.
We will use a four-phase case study design:
1. Part 1: Systematic review of constant observation in hospital for people with dementia and delirium
Part 2: Map the practices and processes of constant observation for people with dementia in three hospitals
2. Co-design an intervention that is locally adapted for each site
3. Test the feasibility and acceptability of the intervention during a three-month implementation in two wards at each hospital
4. Hold a consensus event to agree the key characteristics of the intervention
What will the study achieve?
The main outcome will be evidence on how a priority area of care for hospitals can be used to embed person-centred care and reframe dementia care as skilled, important work. Additionally, we will:
1. Describe current practices and processes for constant observation
2. Assess co-design processes and practices that include people with dementia, their supporters and hospital staff
3. Co-design an intervention and test its feasibility and acceptability in three hospitals
What did the study involve?
In phase 1, we conducted a systematic review and mapped the use of constant observation practices with people with dementia at three study sites. This included:
- +100 hour of observations over 50 periods of observation 7am-10pm in nine wards (across three sites)
- 25 interviews with staff and supporters of people with dementia
- Ward surveys of the use of constant of observations
In phase 2 we will co-design the intervention through a series of site-specific and cross-site meetings over a period of ten months (March 2022 to December 2022). Meetings will be up-to two hours.
- At each site we will recruit up to eight hospital staff and eight people with lived experience of dementia (people living with dementia and/or supporters of people living with a dementia) as co-designers.
In Phase 3 we will test the intervention in the three study sites:
Data collection will occur at three time points (baseline, week 6/7, week 11/12) using the following tools:
- The NOMAD tool
- The Maslach Burnout Inventory (MBI)
- Sense of competence in dementia care staff (SCIDS)
- Cohen-Mansfield Agitation Inventory Observational (CMAI-O)
- Person-centred Care Climate Questionnaire – Staff Version (PCQ-S)
- The Quality of Interactions Schedule (QUIS)
Semi-structured interviews with staff, people with dementia and their supporters will assess perceptions and the acceptability of the intervention. We will also conduct general observations spanning 8am - 10pm.
Further information
If you would like to find out more about the study, please contact Dr Melanie Handley (m.j.handley@herts.ac.uk)
Additional contacts
Professor Rowan Harwood (Rowan.Harwood@nottingham.ac.uk)