George J.E. Crowther, Cathy A. Brennan, Katherine L.A. Hall, Abigail J. Flinders and Michael I. Bennett
People with dementia in hospital are susceptible to delirium, pain and psychological symptoms. These diagnoses are associated with worse patient outcomes, yet are often…
Abstract
Purpose
People with dementia in hospital are susceptible to delirium, pain and psychological symptoms. These diagnoses are associated with worse patient outcomes, yet are often underdiagnosed and undertreated. Distress is common in people experiencing delirium, pain and psychological symptoms. Screening for distress may therefore be a sensitive way of recognising unmet needs. The purpose of this paper is to describe the development and feasibility testing of the Distress Recognition Tool (DRT). The DRT is a single question screening tool that is incorporated into existing hospital systems. It encourages healthcare professionals to regularly look for distress and signposts them to relevant resources when distress is identified.
Design/methodology/approach
The authors tested the feasibility of using the DRT in people with dementia admitted on two general hospital wards. Mixed methods were used to assess uptake and potential mechanisms of impact, including frequency of use, observation of ward processes and semi-structured interviews with primary stakeholders.
Findings
Over a 52-day period, the DRT was used during routine care of 32 participants; a total of 346 bed days. The DRT was completed 312 times; an average of 0.9 times per participant per day. Where participants had an identified carer, 83 per cent contributed to the assessment at least once during the admission. Thematic analysis of stakeholder interviews, and observational data suggested that the DRT was quick and simple to complete, improved ward awareness of distress and had the potential to improve care for people with dementia admitted to hospital.
Originality/value
This is the first short screening tool for routinely detecting distress in dementia in any setting. Its uptake was positive, and if effective it could improve care and outcomes for people with dementia, however it was beyond the scope of the study test this.
Details
Keywords
Peter Tatham, Frank Stadler, Abigail Murray and Ramon Z. Shaban
Whilst there is a growing body of research which discusses the use of remotely piloted aircraft systems (RPAS) (otherwise known as “drones”) to transport medical supplies, almost…
Abstract
Purpose
Whilst there is a growing body of research which discusses the use of remotely piloted aircraft systems (RPAS) (otherwise known as “drones”) to transport medical supplies, almost all reported cases employ short range aircraft. The purpose of this paper is to consider the advantages and challenges inherent in the use of long endurance remotely piloted aircraft systems (LE-RPAS) aircraft to support the provision of medical supplies to remote locations – specifically “medical maggots” used in maggot debridement therapy (MDT) wound care.
Design/methodology/approach
After introducing both MDT and the LE-RPAS technology, the paper first reports on the outcomes of a case study involving 11 semi-structured interviews with individuals who either have experience and expertise in the use of LE-RPAS or in the provision of healthcare to remote communities in Western Australia. The insights gained from this case study are then synthesised to assess the feasibility of LE-RPAS assisted delivery of medical maggots to those living in such geographically challenging locations.
Findings
No insuperable challenges to the concept of using LE-RPAS to transport medical maggots were uncovered during this research – rather, those who contributed to the investigations from across the spectrum from operators to users, were highly supportive of the overall concept.
Practical implications
The paper offers an assessment of the feasibility of the use of LE-RPAS to transport medical maggots. In doing so, it highlights a number of infrastructure and organisational challenges that would need to be overcome to operationalise this concept. Whilst the particular context of the paper relates to the provision of medical support to a remote location of a developed country, the core benefits and challenges that are exposed relate equally to the use of LE-RPAS in a post-disaster response. To this end, the paper offers a high-level route map to support the implementation of the concept.
Social implications
The paper proposes a novel approach to the efficient and effective provision of medical care to remote Australian communities which, in particular, reduces the need to travel significant distances to obtain treatment. In doing so, it emphasises the importance in gaining acceptance of both the use of MDT and also the operation of RPAS noting that these have previously been employed in a military, as distinct from humanitarian, context.
Originality/value
The paper demonstrates how the use of LE-RPAS to support remote communities offers the potential to deliver healthcare at reduced cost compared to conventional approaches. The paper also underlines the potential benefits of the use of MDT to address the growing wound burdens in remote communities. Finally, the paper expands on the existing discussion of the use of RPAS to include its capability to act as the delivery mechanism for medical maggots.