Admiral Nursing—A Model of Specialist Dementia Care in Acute Hospitals

Abstract

Introduction The rising prevalence of dementia has led to increased numbers of people with dementia being admitted to acute hospitals. This demand is set to continue due to an increasingly older population who are likely to have higher levels of dependency, dementia, and comorbidity. If admitted to the hospital, people with dementia are at higher risk of poor outcomes during and following a hospital admission. Yet, there remains a significant lack of specialist support within acute hospitals to support people with dementia, their families and hospital staff. Methods Admiral Nurses are specialists that work with families affected by dementia and provide consultancy and support to health and social care colleagues to improve the delivery of evidenced based dementia care. Historically, Admiral Nurses have predominantly been based in community settings. In response to the increasing fragmentation of services across the dementia trajectory, the Admiral Nurse model is evolving and adapting to meet the complex needs of families impacted upon by dementia inclusive of acute hospital care. Results The Admiral Nurse acute hospital model provides specialist interventions which improve staff confidence and competence and enables positive change by improving skills and knowledge in the provision of person-centred dementia care. The role has the capacity to address some of the barriers to delivering person centred dementia care in the acute hospital and contribute to improvements across the hospital both as a result of direct interventions or influencing the practice of others. Conclusion Improving services for people with dementia and their families requires a whole system approach to enable care coordination and service integration, this must include acute hospital care. The increasing numbers of people with dementia in hospitals, and the detrimental effects of admission, make providing equitable, consistent, safe, quality care and support to people with dementia and their families a national priority requiring immediate investment. The inclusion of Admiral Nursing within acute hospital services supports service and quality improvement which positively impacts upon the experience and outcomes for families affected by dementia.

The impact of hospital-family integrated continuation nursing based on information technology on patients unhealthy mood, family function and sexual function after cervical cancer surgery

“…The rounds model realizes the bedside handover, so that the needs of patients can be solved at the bedside, and zero-distance service is realized. [ 29 ] At the same time, patients with this measure can record the discomfort and needs of the previous day in real time, and report them to the medical staff 1 by 1 during the next day’s rounds, reducing the loss of disease information. The doctor in charge will inform the patients and their families 1 by 1 of the results of the medical examination and the appointment time for the examination.…”

‘It’s just incredible the difference it has made’: family carers’ experiences of a specialist Lewy body dementia Admiral Nurse service

“…In line with previous studies [ 12 ], this contrasted with the lack of knowledge and awareness of LBD that participants reported experiencing within the general health and social care system. In addition to addressing carers’ reported need to better understand the more challenging symptoms of LBD themselves [ 6 ], this theme therefore highlights the importance of the consultancy and training elements of the Admiral Nurse role [ 9 ] for increasing knowledge and awareness of LBD amongst generalist health and social care professionals: something that could help to minimise the delays that people with LBD experience in getting accurate diagnoses and appropriate support [ 6 , 19 ].…”

“…One means of support for carers of people with dementia in the UK is Admiral Nursing: a model supported by the charity Dementia UK, in which registered nurses specialising in dementia care aim to improve the quality of life of families affected by dementia [ 9 ]. Admiral Nurses follow a biopsychosocial approach that includes the provision of information, advice, psychological and emotional support, as well as help and support with coordinating and navigating health and social care services [ 10 ].…”

“…Admiral Nurses follow a biopsychosocial approach that includes the provision of information, advice, psychological and emotional support, as well as help and support with coordinating and navigating health and social care services [ 10 ]. They also train, educate and support generalist health and social care professionals in dementia care [ 9 ].…”

Exploring nurse and nursing student experience of using an artist-produced photobook to learn about dementia

“…Nurses, and nursing students, occupy an important role for people with dementia throughout the course of their disease [21]. As the largest single group of healthcare professionals globally, they have an important role in primary, secondary, and tertiary care, and are likely to support the person from pre-diagnosis to end-of-life care [22][23][24]. Whilst there are many types of dementia education, this study sought to explore the experiences of nurses and nursing students that received dementia education using an artist-produced photobook which depicts the journey of a person living with dementia.…”