Elevating the standard for dementia care in the Emergency Department
October 11, 2024
Being hospitalized can be stressful for anyone. For people living with a cognitive impairment, being in a new environment with unfamiliar people – like an Emergency Department – can lead to escalated and unpredictable behaviour.
Caring for these patients requires specialized knowledge, which is not always covered in standard university education for clinical staff. To fill this gap, Queensway Carleton Hospital (QCH) created a Behaviour Support Registered Nurse (BSRN) role in the Emergency Department (ED).
The five-month pilot project was endorsed by key stakeholders, including the Centre for Aging and Brain Health Innovation (CABHI) which granted QCH temporary funding for the role through the Sparks Program.
The BSRN provided crucial, specialized behavioral assessments and interventions. Using a person-centred approach, the BSRN was able to reduce agitation and create a more compassionate and supportive environment. The role facilitated quicker access to Geriatric Psychiatry services, ensuring patients received timely dementia care from admission onward. They used a home-first philosophy, promoting aging in place and reducing unnecessary hospital admissions.
Families also benefited significantly from the BSRN role, receiving immediate support and guidance throughout their loved ones' ED visits. The BSRN's effective communication and reassurance eased caregiver stress and contributed to a 100 per cent satisfaction rate with the care process.
Additionally, the BSRN role contributed to a safer and healthier working environment for the ED team. By providing specialized education and coaching to 134 front-line staff, the BSRN helped build a more competent and confident workforce. This not only improved patient care but also enhanced job satisfaction and reduced the incidence of distress and injury among staff.
A new binder was created to provide physicians, nurses, and the interdisciplinary team with easy access to essential resources; existing training programs were updated to include specialized dementia care education; and a new 90-minute mandatory training session was introduced for newly hired ED nurses.
Pre-project surveys indicated that 51 per cent of our frontline ED staff felt unsure or neutral about their education in dementia care. After receiving coaching, 81 per cent felt equipped and empowered to provide appropriate care to patients in behavioral emergencies. Roughly 20 per cent of staff requested additional one-on-one coaching and over 60 per cent expressed the need for more educational opportunities. A remarkable 97 percent of staff in the ED supported the idea of making the position permanent.
This comprehensive approach has elevated the standard for dementia care in the ED. By improving patient outcomes, enhancing caregiver experiences, and supporting ED staff, this initiative has demonstrated its value and appropriateness for adoption in addressing the complex needs of patients living with dementia in emergency care scenarios.
About Queensway Carleton Hospital
As the only acute care hospital in West Ottawa, Queensway Carleton Hospital provides quality care to half of the city’s population every year. QCH’s agility and collaborative culture enable it to respond quickly to the most pressing healthcare challenges facing its vibrant and growing communities through advanced programs that reinvent models of patient care. QCH has been named the #1 hospital in Ottawa by Newsweek magazine in 2021 and as a top employer in Canada by Forbes magazine. QCH acknowledges it is located on the traditional and unceded lands of the Anishinabe Algonquin Nation.
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Media Contact
Natasha Curley
Communications Officer
Queensway Carleton Hospital
ncurley@qch.on.ca