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ALASKA PSYCHIATRIC INSTITUTE
PATIENT CARE ASSIGNMENTS
Tag No.: A0397
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Based on record reviews, video review, interviews, and staff education the facility failed to ensure facility staff assigned to patients with dementia had competencies and/or education that met the needs of dementia patients admitted to the psychiatric hospital. Specifically, 4 of the 10 patients reviewed during the survey revealed a primary diagnosis of dementia and/or other organic brain disease with behaviors. The failure to ensure staff had the necessary tools and skills needed to communicate and engage with dementia patients, created a risk for less than optimal care and created a risk for psychological and/or physical harm from other patients and/or staff. Findings:
During an interview on 3/12/19 at 10:35 am, Registered Nurse (RN) #1 stated the facility provided age appropriate developmental training but nothing specific to dementia.
During an interview on 3/12/19 at 10:49 am, PNA #4 stated there was no competencies for dementia, or the difference between delirium, dementia, and delusion.
During an interview on 3/3/12/19 at 11:05 am, PNA (psychiatric nurse assistant) #5 stated there was some online competencies, but nothing extensive pertaining to dementia. The PNA stated staff struggled when caring for patients with sundowners (when dementia patients' behaviors increase in the evenings).
During an interview, on 3/2/19 at 2:45 pm, the Director of Nursing stated facility staff received developmental education but nothing related to dementia and associated behaviors.
According the Alzheimer's Association article "Evidence-Based Interventions for Transition in Care for Individuals Living With Dementia," dated 3/15/19, revealed "Effective approaches appear to be those that involve the individual and caregiver in establishing goals of care, educate the individual and caregiver about likely transitions in care; provide timely communication of information about the individual, create strong inter professional teams with competencies in dementia care, and implement evidence-based models of practice."
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