THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, UK.
Int J Older People Nurs. 2022 Nov;17(6):e12472. doi: 10.1111/opn.12472. Epub 2022 May 16.
People with dementia and other forms of cognitive impairment form a substantial proportion of patients admitted to hospitals, but problems in their care are persistent. One widely proposed improvement approach involves the use of systems using visual identifiers to help staff quickly recognise people with suspected dementia, with the goal of supporting more personalised care. The aim of this paper is to identify the identifier systems in use and staff perceptions of their strengths and weaknesses.
We undertook an online survey of staff providing care for people with dementia in acute and mental health hospitals across the United Kingdom. The questionnaire covered different types of visual identifier systems for dementia. It used categorical and open-response questions to access staff views of their use in practice. Responses were analysed using descriptive statistics, and the Framework approach for free-text answers.
162 responses were received from staff in at least 48 hospitals. Of these, 128 had direct experience of using visual identifier systems. They reported that multiple identifier systems are in use, including schemes with national scope and locally developed approaches. Most respondents reported that more than one system is in use in their hospital. Different types of identifier were seen to have different strengths and weaknesses. Respondents had a broadly positive view of identifiers, but highlighted risks including lack of reliable and consistent use (linked to competing pressures on staff time), lack of staff training, uncertainty about patient and family views, and unclear consent processes.
Our study suggests that a wide range of identifier systems is in use in UK hospitals, with many hospitals using more than one. Further consideration should be given to ensuring that multiple perspectives-including those of patients and carers-are drawn on in optimising their design, resolving ethical issues and supporting implementation.
患有痴呆症和其他形式认知障碍的人在住院患者中占相当大的比例，但他们的护理问题仍然存在。一种广泛提出的改进方法是使用使用视觉标识符的系统来帮助工作人员快速识别疑似痴呆症的患者，以支持更个性化的护理。本文旨在确定使用的标识符系统以及工作人员对其优缺点的看法。
我们对英国各地急性和精神卫生医院为痴呆症患者提供护理的工作人员进行了在线调查。问卷涵盖了用于痴呆症的不同类型的视觉标识符系统。它使用分类和开放式问题来了解工作人员在实践中对其使用的看法。使用描述性统计和开放式回答的框架方法分析响应。
从至少 48 家医院收到了 162 名工作人员的回复。其中，128 人有使用视觉标识符系统的直接经验。他们报告说，正在使用多种标识符系统，包括具有国家范围的计划和本地开发的方法。大多数受访者报告说，他们医院中使用了不止一种系统。不同类型的标识符被认为具有不同的优缺点。受访者对标识符有广泛的积极看法，但强调了风险，包括缺乏可靠和一致的使用（与工作人员时间的竞争压力有关）、缺乏员工培训、对患者和家属意见的不确定性以及不明确的同意程序。
我们的研究表明，英国医院中使用了广泛的标识符系统，许多医院使用了多种系统。应进一步考虑确保从多个角度（包括患者和照顾者的角度）考虑优化其设计、解决伦理问题和支持实施。
