Simulation-based Education To Implement National Clinical Guideline No.21 Guidelines In An Acute Hospital Setting

Abstract Background Non-cognitive symptoms of dementia encompass behavioural, affective and psychotic symptoms that can occur in patients living with dementia. National Clinical Guideline No.21 recommends that a comprehensive assessment should be conducted prior to considering psychotropic medicine to treat non-cognitive symptoms in a person with dementia and that non-pharmacological interventions should be trialled before considering anti-psychotic medication (1). However, 41% of patients with dementia are prescribed new psychotropic and/or existing psychotropic medication is increased during an inpatient admission (2). The aim of this study was to implement National Clinical Guideline No.21 in an acute hospital setting using simulation-based education (SBE). Methods An interdisciplinary simulation scenario focusing on non-pharmacological management of non-cognitive symptoms in patients with dementia was developed. We employed a multi-component intervention approach combing a didactic lecture followed by a simulation scenario and debrief. Healthcare professionals from multiple specialties were invited to participate in simulation scenario which was delivered multiple times over one month. The scenario was facilitated utilising minimal resources and two embedded simulation participants from the Age-Related Healthcare department. The intervention was evaluated using a self-developed questionnaire. Responses were measured on a five-point Likert scale. Results The intervention was conducted three times. Twenty participants completed the questionnaire, including HCPs from occupational therapy (n=3), nursing (n=2), and medicine (n=15). Most (n=13) were previously unaware of National Clinical Guideline No. 21. Following participation, all participants were confident in recognising contributing factors to non-cognitive symptoms of dementia. Fifteen participants agreed they could now manage non-cognitive symptoms. Seventeen participants were confident in their knowledge of when pharmacological measures should be considered. Conclusion This study demonstrates that SBE may be a feasible intervention to implement the management of non-cognitive symptoms of dementia in an acute hospital setting. Next steps should focus on the impact of SBE on clinical practice, including psychotropic medication prescribing and patient outcomes.