THIS SIDEBAR DOES NOT PRINT Creation of a Therapeutic ...of+a+Ther… · Kathleen Curran, MSN;...
1
RESEARCH POSTER PRESENTATION DESIGN © 2012 www.PosterPresentations.com The Alzheimer’s Association reports that 15.2 million Americans now have some form of dementia and the numbers are growing. Dementia patients are often overstimulated in acute care settings and frequently develop a superimposed delirium when ill or during transition. The members of the Regional NICHE Steering team based at Riverside Doctor’s Hospital Williamsburg(RDHW) began exploring an approach to promote patient engagement and safety through development of a Therapeutic Activity Program (TAP). Dementia patients function best when exposed to activities that prevent over or under stimulation through controlled cognitive, sensory, or tactile experiences. Development of a TAP was a collaboration of patients, nursing and volunteers. The purpose of the TAP is to keep patients occupied and engaged in their surroundings. Literature supports divisional activities and non-pharmacological approaches in order to avoid the use of sedatives or physical restraints when the patient becomes restless. What is unknown is if a structured TAP provided on a regular basis will help prevent restless and agitated episodes that sometimes result in the use of physical/chemical restraint. ABSTRACT Nursing staff and volunteers on the RDH steering committee 1) reviewed the literature on use of therapeutic activities in lieu of using pharmacotherapy or restraints, 2) provided education on dementia for nursing and volunteer staff, 3) developed a policy and procedure on use of the TAP, 4) assembled a box of re-usable, infection-control friendly materials that provide stimulation without being demeaning, 5) defined a plan to measure outcomes on patient use, impact on quality of care, and patient/ staff/ family satisfaction. The program will be evaluated by RDHW with plans for adaptation and utilization at the other facilities within the Riverside Health System which include four additional hospitals and ten long term care facilities. GOALS & MEASURES PATIENT Goal: To reduce or eliminate frustration, agitation, and anxiety during patient stay by use of diversional activities enjoyed and decrease the use of or need for medications or restraints. Measures: 1. Staff and the organization will monitor and trend the use of the diversional activities, medications, and restraint use to ensure that evidence based, safe, high quality health care is consistently being provided to our patients. 2. Monitor and trend satisfaction of patient and family, as well as staff, with the use of the diversional activity box. STAFF Goal: To provide current evidence based care alternatives to patients in order to decrease utilization of medications and reduce/ eliminate restraint use in those diagnosed with dementia. (We realize that families of patients with advanced dementia may only feel comfortable with medications and we respect their input into care decisions.) Measures: 1. Monitor staff education and satisfaction in the utilization of the diversional activity box as part of routine patient care. ORGANIZATION Goal: To establish a safe and therapeutic environment for older adult to facilitate their ability to maintain and/or improve their current level of cognition and overall wellness. Measures (facility): 1. Monitor use of sitters and ensure their familiarity with use of diversional activity box. 2. Monitor patient/family/staff satisfaction regarding utilization of diversional activity box as an alternative to medications and/or restraints. 3. Provide visibility and support for NICHE program and its components implementation such as awareness and monitoring of diversional activity box. 4. Provide oversight of the use of medications identified as for cautious use for older adults based on current BEERS criteria. Measures (regulatory): 1. Joint Commission/NICHE crosswalk identifies Joint Commission standards in the areas of leadership, human resources, provision of care, environment of care, performance improvement, information management, nursing, medication management, and rights and responsibilities of the patient. OBJECTIVES DIVERSIONAL ACTIVITY BOX Integral to the program success is the Diversional Activity Box that contains activities that are facilitated by our staff , family members and/or special trained volunteers. Based on patient abilities, cognitive function and willingness to participate, appropriate items are selected and used to decrease agitation, confusion and anxiety and increase trust, comfort and cognition. FUTURE PLANS For a patient with dementia, any disruption to a normal routine can be very stress producing. That stress added to an illness or injury and admission to the hospital can be devastating. Studies have shown that increased cognitive stimulation and human interaction are vital to well- being while declining sensory and cognitive functions coupled with illness, boredom, fear and loneliness can negatively effect wellbeing. It is our goal here at Riverside Doctors’ Hospital Williamsburg to create and implement a Diversional Activity Protocol/Pathway that would include physician orders for an individualized plan of activity for not only our dementia patients, but for any patient that would benefit from any of our therapeutic activities. Activities are designed to support, challenge and enhance the psychological, spiritual, social, emotional and physical wellbeing of individuals. Nursing staff and a group of specially trained volunteers have already initiated diversional activities with our patients with overwhelmingly positive outcomes. We look forward to further data collection and publication of the results of our new protocols/policy. RESOURCES Diversional Therapy. http://www.agedcarecrisis.com. 4 Feb 2008. The Diversional Therapy of Australia National Conference Ltd. (DTAANC). Accessed 5 March 2015. Joint Commission and CMS Crosswalk. January 1,2014. Joint Commission Resources; 1 edition Sensory Boxes & Other Ideas to Stimulate the Senses. http://www.goldencares.com/activities/sensory/sensory-boxes. Accessed 5 March 2015. What is dementia? Alzheimer's Association. http://www.alz.org/what-is-dementia.asp. Accessed Nov. 18, 2014. Kathleen Curran, MSN; Joyce VanNatta, MSN; Gayle Busch, BSN Riverside Doctors’ Hospital, Williamsburg, Virginia Creation of a Therapeutic Activity Program (TAP) for Patients with Dementia across Settings Diversion Family Music Pets Reminiscence Activity Reminiscence Therapy Intake Sheet
Transcript of THIS SIDEBAR DOES NOT PRINT Creation of a Therapeutic ...of+a+Ther… · Kathleen Curran, MSN;...
RESEARCH POSTER PRESENTATION DESIGN © 2012
www.PosterPresentations.com
(—THIS SIDEBAR DOES NOT PRINT—)
D E S I G N G U I D E
This PowerPoint 2007 template produces a 42”x72” presentation
poster. You can use it to create your research poster and save
valuable time placing titles, subtitles, text, and graphics.
We provide a series of online answer your poster production
questions. To view our template tutorials, go online to
PosterPresentations.com and click on HELP DESK.
When you are ready to print your poster, go online to
PosterPresentations.com
Need assistance? Call us at 1.510.649.3001
Q U I C K S T A R T
Zoom in and out As you work on your poster zoom in and out to the level that is
more comfortable to you. Go to VIEW > ZOOM.
Title, Authors, and Affiliations Start designing your poster by adding the title, the names of the authors, and the
affiliated institutions. You can type or paste text into the provided boxes. The
template will automatically adjust the size of your text to fit the title box. You can
manually override this feature and change the size of your text.
T I P : The font size of your title should be bigger than your name(s) and institution
name(s).
Adding Logos / Seals Most often, logos are added on each side of the title. You can insert a logo by
dragging and dropping it from your desktop, copy and paste or by going to INSERT >
PICTURES. Logos taken from web sites are likely to be low quality when printed.
Zoom it at 100% to see what the logo will look like on the final poster and make any
necessary adjustments.
T I P : See if your company’s logo is available on our free poster templates page.
Photographs / Graphics You can add images by dragging and dropping from your desktop, copy and paste,
or by going to INSERT > PICTURES. Resize images proportionally by holding down
the SHIFT key and dragging one of the corner handles. For a professional-looking
poster, do not distort your images by enlarging them disproportionally.
Image Quality Check Zoom in and look at your images at 100% magnification. If they look good they will
print well.
ORIGINAL DISTORTED
Corner handles
Go
od
pri
nti
ng
qu
alit
y
Bad
pri
nti
ng
qu
alit
y
Q U I C K S TA R T ( c o n t . )
How to change the template color theme You can easily change the color theme of your poster by going to the DESIGN
menu, click on COLORS, and choose the color theme of your choice. You can
also create your own color theme.
You can also manually change the color of your background by going to VIEW
> SLIDE MASTER. After you finish working on the master be sure to go to
VIEW > NORMAL to continue working on your poster.
How to add Text The template comes with a number of pre-formatted
placeholders for headers and text blocks. You can
add more blocks by copying and pasting the existing
ones or by adding a text box from the HOME menu.
Text size Adjust the size of your text based on how much content you have to
present. The default template text offers a good starting point. Follow the
conference requirements.
How to add Tables To add a table from scratch go to the INSERT menu and click on
TABLE. A drop-down box will help you select rows and columns.
You can also copy and a paste a table from Word or another PowerPoint
document. A pasted table may need to be re-formatted by RIGHT-CLICK >
FORMAT SHAPE, TEXT BOX, Margins.
Graphs / Charts You can simply copy and paste charts and graphs from Excel or Word. Some
reformatting may be required depending on how the original document has
been created.
How to change the column configuration RIGHT-CLICK on the poster background and select LAYOUT to see the column
options available for this template. The poster columns can also be
customized on the Master. VIEW > MASTER.
How to remove the info bars If you are working in PowerPoint for Windows and have finished your poster,
save as PDF and the bars will not be included. You can also delete them by
going to VIEW > MASTER. On the Mac adjust the Page-Setup to match the
Page-Setup in PowerPoint before you create a PDF. You can also delete them
from the Slide Master.
Save your work Save your template as a PowerPoint document. For printing, save as
PowerPoint of “Print-quality” PDF.
Student discounts are available on our Facebook page.
Go to PosterPresentations.com and click on the FB icon.
© 2013 PosterPresentations.com
2117 Fourth Street , Unit C
Berkeley CA 94710
The Alzheimer’s Association reports that 15.2 million Americans now have some form of
dementia and the numbers are growing. Dementia patients are often overstimulated in
acute care settings and frequently develop a superimposed delirium when ill or during
transition. The members of the Regional NICHE Steering team based at Riverside Doctor’s
Hospital Williamsburg(RDHW) began exploring an approach to promote patient
engagement and safety through development of a Therapeutic Activity Program (TAP).
Dementia patients function best when exposed to activities that prevent over or under
stimulation through controlled cognitive, sensory, or tactile experiences. Development of
a TAP was a collaboration of patients, nursing and volunteers. The purpose of the TAP is
to keep patients occupied and engaged in their surroundings. Literature supports
divisional activities and non-pharmacological approaches in order to avoid the use of
sedatives or physical restraints when the patient becomes restless. What is unknown is if
a structured TAP provided on a regular basis will help prevent restless and agitated
episodes that sometimes result in the use of physical/chemical restraint.
ABSTRACT
Nursing staff and volunteers on the RDH steering committee 1) reviewed the literature on use of
therapeutic activities in lieu of using pharmacotherapy or restraints, 2) provided education on
dementia for nursing and volunteer staff, 3) developed a policy and procedure on use of the TAP,
4) assembled a box of re-usable, infection-control friendly materials that provide stimulation
without being demeaning, 5) defined a plan to measure outcomes on patient use, impact on
quality of care, and patient/ staff/ family satisfaction. The program will be evaluated by RDHW
with plans for adaptation and utilization at the other facilities within the Riverside Health
System which include four additional hospitals and ten long term care facilities.
GOALS & MEASURES
PATIENT
Goal: To reduce or eliminate frustration, agitation, and anxiety during patient stay by use of
diversional activities enjoyed and decrease the use of or need for medications or restraints.
Measures:
1. Staff and the organization will monitor and trend the use of the diversional activities,
medications, and restraint use to ensure that evidence based, safe, high quality health care is
consistently being provided to our patients.
2. Monitor and trend satisfaction of patient and family, as well as staff, with the use of the
diversional activity box.
STAFF Goal: To provide current evidence based care alternatives to patients in order to decrease
utilization of medications and reduce/ eliminate restraint use in those diagnosed with dementia.
(We realize that families of patients with advanced dementia may only feel comfortable with
medications and we respect their input into care decisions.)
Measures:
1. Monitor staff education and satisfaction in the utilization of the diversional activity box as
part of routine patient care.
ORGANIZATION Goal: To establish a safe and therapeutic environment for older adult to facilitate their ability
to maintain and/or improve their current level of cognition and overall wellness.
Measures (facility):
1. Monitor use of sitters and ensure their familiarity with use of diversional activity box.
2. Monitor patient/family/staff satisfaction regarding utilization of diversional activity box as
an alternative to medications and/or restraints.
3. Provide visibility and support for NICHE program and its components implementation such as
awareness and monitoring of diversional activity box.
4. Provide oversight of the use of medications identified as for cautious use for older adults
based on current BEERS criteria.
Measures (regulatory):
1. Joint Commission/NICHE crosswalk identifies Joint Commission standards in the areas of
leadership, human resources, provision of care, environment of care, performance
improvement, information management, nursing, medication management, and rights and
responsibilities of the patient.
OBJECTIVES
DIVERSIONAL ACTIVITY BOX
Integral to the program success is the Diversional Activity Box that contains activities that are
facilitated by our staff , family members and/or special trained volunteers. Based on patient
abilities, cognitive function and willingness to participate, appropriate items are selected and
used to decrease agitation, confusion and anxiety and increase trust, comfort and cognition.
FUTURE PLANS
For a patient with dementia, any disruption to a normal routine can be very stress producing.
That stress added to an illness or injury and admission to the hospital can be devastating.
Studies have shown that increased cognitive stimulation and human interaction are vital to well-
being while declining sensory and cognitive functions coupled with illness, boredom, fear and
loneliness can negatively effect wellbeing. It is our goal here at Riverside Doctors’ Hospital
Williamsburg to create and implement a Diversional Activity Protocol/Pathway that would
include physician orders for an individualized plan of activity for not only our dementia patients,
but for any patient that would benefit from any of our therapeutic activities.
Activities are designed to support, challenge and enhance the psychological, spiritual, social,
emotional and physical wellbeing of individuals. Nursing staff and a group of specially trained
volunteers have already initiated diversional activities with our patients with overwhelmingly
positive outcomes. We look forward to further data collection and publication of the results of
our new protocols/policy.
RESOURCES
Diversional Therapy. http://www.agedcarecrisis.com. 4 Feb 2008. The Diversional Therapy of
Australia National Conference Ltd. (DTAANC). Accessed 5 March 2015.
Joint Commission and CMS Crosswalk. January 1,2014. Joint Commission Resources; 1 edition
Sensory Boxes & Other Ideas to Stimulate the Senses.
http://www.goldencares.com/activities/sensory/sensory-boxes. Accessed 5 March 2015.
What is dementia? Alzheimer's Association. http://www.alz.org/what-is-dementia.asp. Accessed
Nov. 18, 2014.
Kathleen Curran, MSN; Joyce VanNatta, MSN; Gayle Busch, BSN Riverside Doctors’ Hospital, Williamsburg, Virginia
Creation of a Therapeutic Activity Program (TAP) for Patients with Dementia across Settings
Diversion
Family Music
Pets
Reminiscence
Activity
Reminiscence Therapy Intake Sheet
