MENTAL HEALTH FEATURE impairment that is experienced by patients in our care impacts on theirs and the staff ’ s ability to engage in unstructured meaningful activity .
Currently the ward is offered music interventions ; however , due to limited resources this is only offered on a weekly basis for 45 minutes . The facilitator offers live music , in addition to other activities including the use of percussion instruments and the use of digital technology .
These sessions are delivered in a group setting , which on occasions can be challenging due to the behaviours that we observe and the varying functioning of the patient group .
A Continuous Quality Improvement was initiated using the problem statement template to consider what is happening now , the impact that individualised playlists on wireless headphones could have on incidences of violence and aggression , increasing opportunities to access activity and increasing patient and staff wellbeing and engagement .
Additional impacts that were aims of the initiative included improving physical health and increasing opportunities for social interaction .
For the testing phases we used the ‘ plan , do , study and act ’ ( PDSA ) cycles . This enabled the team to keep on track with where we were in our process , as well as recognising what we had learnt so far and what further plans this learning enabled .
The team ensured the project was collaborative throughout by engaging staff and patients on Aspen with questionnaires regarding the project . Five out of the eight patients admitted to the ward during this time completed the questionnaire , which identified if they had an interest in music , how music impacted on their mood and what opportunities there were to access music .
All patients reported enjoying listening to music ; however many of them had difficulties reflecting on how it made them feel and were unsure if they wanted more opportunities to access music activities .
Ward staff were asked similar questions if they felt that further access to music sessions would be beneficial to the patients to aid relaxation , reminiscence and increase potential engagement between staff and patients .
The intervention was trialled with initially one patient . Due to the patient ’ s limited verbal communication skills , discussions were had with his family to generate a list of his favourite artists and songs , which were then put onto wireless headphones .
To outcome the intervention pictorial likert scales were created for the patient to complete , to measure his wellbeing before and after the intervention . Staff who were present during the session were also asked to complete similar scales to allow for a different
EVIDENCE LINK
Isaac et al ( 2021 ) conducted a quasi-experimental intervention study in five rural nursing homes in Australia to evaluate the outcomes of ‘ Harmony in the Bush ’, a co-designed dementia care model integrating Progressively Lowered Stress Threshold ( PLST ) principles and person-centred music . Care home staff participated in PLST-based training workshops , and residents were provided with person-centred care plans and personalised playlists . Baseline and postintervention measures recorded residents ’ levels of agitation and staff stress . Findings included : statistically significant decline in aggressive , physically nonaggressive , verbally agitated , and hiding and hoarding behaviours ; and reduction in staff stress . However , some behaviours ( for example : hitting , kicking , throwing things ) increased . The authors suggest the study provides promising evidence regarding the model but identify the need for further research .
Reference Isaac V , Kuot A , Hamiduzzaman M , Strivens E , Greenhill J ( 2021 ) The outcomes of a person-centered , nonpharmacological intervention in reducing agitation in residents with dementia in Australian rural nursing homes . BMC Geriatrics , 21 : 193 , 1 – 11 . doi : 10.1186 / s12877-021-02151-8
perspective , but also to account for those patients who were unable to engage in these tools .
In addition , a dementia care map ( DCM ) was completed , which is a method of continuous staff observations of the behaviour of patients with dementia and the care they receive .
The three outcome measures that were used identified a general improvement in the patient ’ s wellbeing after receiving the intervention – accessing the headphones for an hour ’ s duration of listening to music . Overall , we believe this demonstrated the positive affect music has on a patient ’ s wellbeing , while continuing to promote patient centred care .
References
Marshall CA , McIntosh E , Sohrabi A and Amir A ( 2020 ) Boredom in inpatient mental healthcare settings : a scoping review . British Journal of Occupational Therapy , 83 ( 1 ), 41-51
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