Annual Report and Accounts 2012/13 - Royal Devon & Exeter Hospital

2. Progress on our
2012/13 Priorities
Royal Devon and Exeter NHS Foundation Trust
Quality Report 2012/13
11
Forget me not
We introduced the Forget Me Not
campaign to improve communication
with patients who have any form of
mental illness. For this campaign, we
are working with our colleagues in
mental health at Devon Partnership
NHS Trust.
Forget Me Not aims to benefit anyone
struggling to communicate their
needs and preferences, for whatever
reason. The new campaign symbol,
a Forget Me Not flower, tells staff
that the patient needs a little more
time, sensitivity and skill to support
their journey through services. The
campaign symbol is available in
magnetic and sticker form so that
it can be placed on the bed, ward
whiteboard, request forms or notes
of any patient displaying symptoms of
cognitive impairment.
This initiative aims to:
• Increase interaction time and
frequency of contact with patients
• Increase the therapeutic quality of
interactions
• Improve patient and carer
experiences
• Promote a culture of
person-centred care
• Reduce staff stress.
Training
Consultant Nurse for Older People,
Debbie Cheeseman, also developed
a training package for all Trust staff.
She held a series of one-hour lectures
throughout February and March 2013,
which was in plain English and suitable
for both clinical staff and those in
support services. This will continue into
the new financial year.
As well as highlighting the
demographics which make this such
an important issue for the RD&E, the
training gave staff some top tips on
how to help patients who may be
disorientated or confused.
Top tips when caring for a person with
dementia:
• Remember that this is a person
with dementia and not just
symptoms of their condition
• Look for the person behind
the dementia – try to find out
something about their life
• Complete the ‘This is Me’
document with family to give
some insight and information into
this person’s life. This can help find
areas for engagement
• About 90% of communication
is non-verbal – think about body
language, gestures and facial
expressions
• Effective communication takes
time and patience
• Respond to emotions not just
words – does the person seem
unhappy or distressed?
• Ensure the person can see you –
position yourself at their level and
maintain eye contact
• So called ‘problem behaviour’
is nearly always an attempt to
communicate feelings or needs.
Rather than trying to stop the
behaviour try to work out what
it means
• Focus on what the person can do
and play to their strengths
• Involve the family in their care –
they will know the person well
and how to respond to things.
Observational audits
Our Nurse Consultant for Older People,
Debbie Cheeseman, introduced a
programme of observational audits
covering all clinical areas in the Trust,
including theatres and outpatient
departments. Each area receives two
observations of care: one carried out
by Debbie and a Ward Matron and the
other carried out by Debbie and an
independent observer, who may be a
member of staff from another area or
a student or carer. On each visit, the
observers watch all patient interactions
for an hour. Staff are given immediate
feedback about their approach
towards patients and the Matron is
advised of the care observed.
This has been a very powerful teaching
tool for all staff involved. A lot of
excellent care has been seen and
feedback given so that staff are aware
they should continue to role model
that good behaviour. One consistent
observation is how little eye contact
patients receive from us unless it’s their
‘turn to have care’. This will now form
part of a formal research proposal.
In the meantime this work is being
shared at the one hour awareness
session ‘Our population is changing’ so
that staff are learning how eye contact
particularly affects patients who have a
delirium or dementia.