Authors (including presenting author) :
Yeung KC(1), Kwok AML(2), Cheung SY(1), Sze SYM(1), Wong CS(2), Koo KKT(2), Chan WH(3), Wong JYY(3), Lam PL(4), Huang CH(4), Kong PT(5), Chan ML(6)
Affiliation :
(1)Medicine and Geriatrics, Shatin Hospital, (2)Central Nursing Division, Bradbury Hospice, Cheshire Home Shatin and Shatin Hospital, (3)In-patient Unit, Bradbury Hospice, (4) Dependent Unit, Cheshire Home Shatin, (5) Psychiatry, Shatin Hospital, (6)Surgical, Shatin Hospital
Introduction :
With the association of dementia and population ageing, more older patients with dementia were admitted to hospitals in Hong Kong (Yu et al, 2012). Physical restraints are often applied for the behavioural and psychological symptoms of dementia (BPSD). As part of patient-centred care, the Department of Medicine and Geriatrics (M&G) at Shatin Hospital (SH) has adopted a restraint-free care environment since 2007. Alternatives to physical restraint are offered to minimize patient falls.
For patients with cognitive deficit, it was challenging to adapt an unfamiliar environment (Crelline et al., 2013). This was compounded by the severe restrictions to hospital visitation under COVID-19 pandemic. To facilitate family communication, technologies such as video-conference calls was introduced to in-patient wards.
To enhance the dementia care, program of the Advanced Nurse-Aid Robot was piloted in 2020. Based on the experiences and results, the program is expanded to sub-acute wards in Bradbury Hospice(BBH), Cheshire Home Shatin (SCH) and SH.
Objectives :
1. To prevent in-patient falls while minimizing physical restraint application;
2. To enhance dementia care in subacute medical wards;
3. To facilitate communication between patients and families during the COVID-19 pandemic;
4. To evaluate the level of satisfaction of ward staff towards the Advanced Nurse-aid Robot.
Methodology :
Staff trainings were conducted before the application of 10 Advanced Nurse-aid Robot, Temi, in BBH, SCH and SH in Nov 2022. Robot Temi automatically performed patrol rounds in sub-acute wards, with the patient reminders targeting clinical risks including patient falls, medications and infection outbreaks. Education videos were broadcast to newly admitted patients to reinforce safety and fall prevention.
Temi provided reality orientation to dementia patients by announcing the date and day of the week during patrol rounds. Cognitive training in the form of videos and computerized games were offered as diversional therapy.
To facilitate family communication and bonding, virtual visits through real-time video-conference calls were facilitated by Temi.
Result & Outcome :
Result & Outcome:
1. In-patient fall rates
After the application of robot, patients fall rate in SH (0.09) was lower when comparing to the same period in 2021 (0.40) and the overall rate in all rehabilitation hospitals (0.27). Relevant data will further be monitored.
2. BPSD severity and Carer distress
The pre and post comparison was done by Neuropsychiatric Inventory Questionnaire.
In pilot program (n=15)
• Mean BPSD severity score: 11.9 (pre) to 8.6 (post)
• Mean Carer stress score: 17.3 (pre) to 11.4 (post)
3. Patient and staff satisfaction
Patients and nurses will be invited to evaluate the level of satisfaction.
In pilot program (n=182)
• ≥ 95% positive feedback in fall prevention and infection control
• ≥80% positive feedback in family communication and emotion control
4. Usage of functions
Screen time apps was installed to monitor the usage of functions.
Conclusion
Following the positive findings in the pilot program, the program has been promoted in cluster based.
