Something to talk about


An award-winning resource is giving staff the information they need to increase patient engagement, writes Jennifer Trueland

On a drive with her husband recently, nursing auxiliary Betty Maxwell was excited to see a sign for a waterfall near a well-known Scottish beauty spot. She had been told about the attraction near Loch Lomond by a patient, who had shared with her the joy that she and her family had experienced on similar days out. The conversation had come about as a result of an award-winning project that was started in Pavilion 3, a slow-stream rehabilitation ward for older people at Ayrshire Central Hospital. Staff had identified a lack of meaningful activity and stimulation for patients and came up with the idea of a toolkit. ‘Pocket Ideas – for a moment in time’ is a portable toolkit that staff can use to spark conversations with patients, some of whom have cognitive difficulties. The pocket-sized book encourages discussion and activity through a mixture of quick activities, pictures, inspirational stories and games, as well as conversation starters, such as in the case above, discussing favourite places for a day out with the family. The idea – as the name suggests – is to grab a moment in time to engage with a patient, either purposefully, such as when someone is sitting in the day room, or while completing a task, such as when helping someone to dress. Ms Maxwell admits she was unsure about the project at first. ‘I didn’t know how we would manage to find the time to do it,’ she says frankly. ‘But it has been really useful. It gives you ideas and helps you build good relationships with patients.’ Andrea Boyd was one of the occupational therapists behind the project, which was recently

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named best acute care initiative in Scotland’s Dementia Awards. She joined Pavilion 3 following a spell of working in the community. ‘Pavilion 3 is an incredibly busy ward and staff were working hard to support patients, but there was a lack of meaningful activity,’ she says. ‘The main source was the television. We wanted to find a way of engaging patients in activities and encouraging staff to be involved.’ An activity working group was set up in August 2013, comprising the occupational therapists team, who came up with the notion of Pocket Ideas. ‘We wanted to find a way of embedding activity as part of the rehab process,’ she says. ‘We wanted it to be a useful and usable tool that staff would carry around in their uniform pockets.’ The team discussed the project with the then ward sister Linda Anderson, who was very supportive, and nursing staff helped develop the ideas for the toolkit.

Recognising excellence This year more than 90 applications were received for Scotland’s Dementia Awards. NHS Ayrshire and Arran won the best acute care initiative category for ‘Pocket Ideas – a moment in time’. Runners up in the same category were an NHS Lothian project called ‘Room for Change’ and NHS Fife’s ‘Dementia Champions Network’. ‘Room for Change’ involved transforming a ward at Edinburgh’s Western General Hospital into a more welcoming environment. It included using specially designed signage to alleviate confusion among patients. The ‘Dementia Champions Network’ is a forum for dementia champions across NHS Fife and Fife social services to exchange ideas, share successes and discuss the challenges they face. Go to

Conversation prompts


A prototype was created, which included laminated pages with inspirational quotations, photographs (including local beauty spots), games and simple questions designed to prompt a five-minute conversation. This was completed in December last year and piloted from January. ‘We wanted to help the therapeutic relationship between staff and patients,’ says Ms Boyd. ‘Sometimes a hospital stay can be a scary experience; it can feel a bit chaotic. But we know that meaningful activity boosts Staff on a rehabilitation ward in an Ayrshire hospital have developed an award-winning portable toolkit that prompts conversation with patients and encourages activity. The initiative has inspired more meaningful engagement with patients without adding to staff’s workload. Author Jennifer Trueland is a freelance journalist

mood. Staff were keen to do what they could to look after people’s mental health, as well as their physical health.’ The prototype was evaluated with a simple tool designed by the activity working group. ‘The response from staff, patients and their families was overwhelmingly positive,’ she says. Pocket Ideas really is about “a moment in time” – it is designed to take five to ten minutes, and can be about a conversation you can have when you are doing something else, such as giving people medication, or helping them to stand.’ She adds that the beauty of it is that you can open any page in the book for inspiration, and patients’ families and friends can use it too. The project has been so successful that Ms Boyd is working on a new version of the book, which will be professionally

printed and distributed, initially in NHS Ayrshire and Arran. It is good news for Pavilion 3, where the initial prototypes are still in use. Deputy charge nurse Lesley Brown, one of the first to trial it, says ‘the simplest things’ can improve interactions with patients. ‘Usually you would ask someone about his or her family, but the book suggests asking other things, such as talking about past trips that the patient has made. Someone told me about meeting Princess Diana – it gives people an opportunity to talk about what has been special for them in their lives.’

Spreading the word

No specific dementia outcomes have been tested, but anecdotal evidence from patients with and without dementia, and families, indicates that the toolkit lifts mood. But does it add to staff’s workload? ‘It doesn’t have any impact on the working day,’ she says. ‘It fits in with what we are doing and helps us to get to know the patients better.’ She is pleased that the project is to be expanded to other settings. ‘I think it should be rolled out further. If everyone gets similar results with it – even if it is just used once or twice a day – then I think it would make a difference.’ Ms Maxwell says that nursing and auxiliary staff, as well as patients, get a lot of enjoyment from using the book. She particularly enjoys a section that mentions traditional Scottish words. ‘We ask patients if they remember “gutties” (sand shoes), ‘birling’ (dancing) or ‘keekin’ glass’ (mirror). ‘The good thing is that it starts a conversation off and then one thing leads to another. Sometimes if we are in the day room the patients will ask if we can use it – they really like it,’ she says. It’s great – and it has also given me some tips for good places to visit’ NS

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Something to talk about.

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