CARE TALKS Sustaining Practice Now That The Project Is Officially - - PowerPoint PPT Presentation

CARE TALKS

Sustaining Practice Now That The Project Is ‘Officially’ Over

More of this

And less of this

Some History

The Unit

• 75 Long Term Care Beds
• June 2013: 26% use of inappropriate

antipsychotics (1/3 of the unit population)

• Joined the Alberta Health Services Early

Adopter Group due to high use (over 20%)

• January 2014: 100% reviewed with an anti-

psychotic rate of 15%

• To date: 100 % reviews completed with a

antipsychotic rate of 8%

Issues and Concerns

• Many of the residents were non-

communicative and drowsy

• Increased use of large Broda-type chairs
• Poor on-going assessment of need,

antipsychotics automatically reordered when review due

• Antipsychotics were requested immediately

by staff for all types of responsive behaviors particularly on Evening shifts

Project goals

• To review each resident on antipsychotics

monthly.

• To decrease to the point of discontinuation

antipsychotic medications.

• To educate staff about responsive

behaviours and non pharmacological interventions.

• To educate families about antipsychotic

medication and inform them of this project.

Successes

• Immediate drop in the number of

antipsychotics used and prescribed

• Two successful discontinuations of

medications with no negative resident

• utcomes
• Residents with discontinued medications

were more able to participate in their care

• Positive support from physicians and families

How do we stay the Course? Two levels of support and actions were required: 1) Locally at the site 2) Organizationally

How do we stay the Course? Locally

• Celebrating and communicating our

successes was essential

• Education and leadership - mentoring was

essential

• The stories and the residents themselves
• ffered the most motivation to keep going
• Our Motto: DARE TO TRY

How do We Stay the Course? Organizationally

• CapitalCare Strathcona shared our

resident stories with our organization in

• ur People and Progress newsletter and

in organizational meetings with our actual statistics.

• We began our own internal AUA

collaborative supported by AHS and Lead by one of our executive .

How do We Stay the Course? Organizationally

• Our policies reflect the need for staff to

know and understand how to respond to folks with responsive behaviours.

• Policies are being updated to clearly

articulate best practice related to the use of antipsychotic medication with the elderly particularly those with dementia. .

What Have We Learned?

• What gets measured gets done.
• Clear communication about the goal and on-

going conversations with staff and families is essential.

• Start slow with a couple of easy interventions

that will be successful.

• Leadership is key and a team commitment is

required - everybody has to try.

• Always bring it back to the residents and how

they are benefiting.