Title: A preliminary comparison of wards for people with dementia using patient engagement time with other wards delivering standard care alone
Funder: Department of Health (England)

Abstract: Background Protected Engagement Time (PET) for people with dementia is a new method of patient staff interactions where the ward is closed to all visitors for a specified period during the day so that ward staff can be released from office duties so they can focus on interaction and activity with the patients. PET was developed on acute psychiatric wards in Oxford (Kent 2004) because nurses were not spending enough time with patients. Lack of individual time including conversations with their nurses is an issue identified by inpatients in dementia care (Edvardsson & Nordvall 2007). There is largely anecdotal evidence that PET improves patients' experience of care but we do not have evidence that PET benefits people with dementia and their staff or how it should be implemented. Aims The overall aim of this pilot study is to assess the impact of PET in dementia care settings. We will compare wards on which PET is currently implemented with otherwise similar local wards where it is not. We have followed a prospective observational cohort design as a similar design has been adopted to examine PET in acute psychiatry in an RfPB funded project designed by two researchers in our team. There is an urgent need for preliminary evidence as to how the model has been implemented and whether there is evidence of positive effects. The prospective cohort method, will also allow us to assess whether a subsequent cluster randomised trial of a more clearly operationalised version of PET, outlined in the fidelity scale developed in the course of the study in dementia care is warranted. Plan of Investigation The study will involve 4 main components: 1. Development of a draft measure of fidelity for PET 2. A telephone survey of wards in England to see how PET in dementia care is implemented 3. A comparison of patient health quality of life and experiences of ward care, the quantity and nature of staff-patient interactions and staff burnout between 3 wards with PET and 3 wards without in 3 sites; Norwich, London and Brighton.The secondary hypotheses are that on PET wards people with dementia will have increased satisfaction with treatment, reduced agitation and aggression, reduced use of prescribed tranquilliser medication, staff will be less burnt out, and the staff / patient contact will be greater 4. An exploration of patient, staff and key stakeholder experiences of PET on 3 wards Potential Impact Although PET is used with people with dementia it has not as yet been quantified or evaluated. Anecdotal evidence indicates enthusiasm from clinicians to implement it as a way of improving quality of care. However, no evidence is available on its effect and cost implications, or on how best to do this. This study will supply preliminary evidence as to whether PET should be sustained and further disseminated. It may also provide evidence for a larger scale randomised controlled study in which a model of PET can be evaluated. We do not know if this is feasible and therefore are proposing a 4 stage pilot investigation, which will be linked with an ongoing pilot study of PET in acute care, with sharing of some research measures to ensure the best use of publicly funded research monies


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: NEUROLOGICAL