IMPLEMENTING BEST PRACTICE GUIDELINES FOR DELIRIUM, DEMENTIA AND DEPRESSION: A CITY-WIDE APPROACH

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH
Laurie McKellar RN(EC), BScNNurse Practitioner
on Geriatric Consult - Liaison Team, St.
Josephs Health Care London (SJHC) and
London
Health Sciences Centre (LHSC) Ann Jarvie RN,
MScNClinical Nurse Specialist, Regional
Psychogeriatric ProgramParkwood Hospital - St.
Josephs Health Centre for the The London 3Ds
Group

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH

• Declaration
• There are no conflict(s) of interest that
• have a direct bearing on the subject
• matter of this presentation.

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH
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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH

• RNAO Best Practice
• Spotlight Organization
• Are health-care organizations
• selected by the Registered
• Nurses Association of Ontario
• (RNAO) through a Request for
• Proposals process to implement,
• evaluate and share lessons
• learned from their guideline
• experiences and research
• findings.

• In March 2006 both LHSC and SJHC were selected to
  be Best Practice Spotlight Organizations
  (candidate)
• LHSC committed to implement the RNAO Best
  Practice Guideline Screening for Delirium,
  Depression and Dementia in Older Adults
• SJHC committed to implement the RNAO Best
  Practice Guideline Caregiving Strategies for
  Older Adults with Delirium, Dementia and
  Depression

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH

• London Health Sciences Centre (LHSC)
• Medicine Program Units
• at University Hospital
• and Victoria Hospital
• Acute Medicine
• Family/Palliative Care Medicine
• Acute Care of the Elderly
• Respirology Medicine
• Medicine Triage Unit

• St Josephs Health Care- London (SJHC)
• Rehabilitation Units GRU/MSK at Parkwood Site
• Long Term Care Unit Veterans Care at Western
  Counties Wing at Parkwood Site
• Geriatric Mental Health
• Unit
• L1 at Regional Mental Health Care London

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH

• London 3 Ds Group
• APNs from both organizations met to consider
  participating in a research project as an RNAO
  Best Practice Spotlight Organization (candidate)
• Group expanded and met in June, 2006 to discuss
  an opportunity to jointly participate in this
  research project about the 3Ds

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH

• London 3 Ds Group
• Group decided that it was premature to do
  research
• London 3D Group formed
• Members are from
• - multiple disciplines
• - multiple roles
• - several of the
• implementing Units

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH

• As the interdisciplinary London 3Ds Group
• continues to evolve, the following
• outcomes have been achieved
• Group consensus to use an interdisciplinary
  city-wide approach to implement the 3Ds BPGs
  (RNAO CCSMH Guidelines) in SJHC and LHSC to
  enhance consistency in elder care and to minimize
  gaps.
• Commitment to engage in research in the future
• Visioning exercise development of a logic model

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH

• Implementation Activities
• Partnering with RNAO to develop E-learning
• Developing curriculum content (from RNAO and
  CCSMH guidelines) for face to face education
  sessions with staff
• Meeting with unit leaders to develop a process to
  implement the guidelines
• Developing an evaluation process

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IMPLEMENTING BEST PRACTICE GUIDELINES FOR
DELIRIUM, DEMENTIA AND DEPRESSION A CITY-WIDE
APPROACH

• Why are we doing this?
• To build healthcare providers skill, knowledge,
  comfort and confidence re3Ds
• To improve more accurate and earlier diagnosis on
  the 3Ds
• To improve safety of patients, family and staff
• To decrease mortality and morbidity associated
  with the 3Ds through early diagnosis
• To improve Elder Care