Nonpharmacologic Interventions Win QI Award
A passion for quality improvement, a creative mind, and an innovative idea. These are the key ingredients in an AMDA Foundation Quality Improvement (QI) award winner. Just ask Marian McNamara, RN, MSN, 2014 award recipient for "Reduction of Antipsychotic Medication in the Long-Term Care Dementia Population Utilizing Novel Non-Pharmacological Approaches." After seeing that her facility, New York-based Sea View Hospital Rehabilitation Center and Home, had a higher than average rate of antipsychotic usage, Ms. McNamara wanted to do something. "We brainstormed about nonpharmacologic interventions we could implement. We involved team leaders and staff, as well as family members," she said. As a result, they identified several promising ideas and didn't waste time implementing them.
"We got some funding for a music and memory program. We purchased iPods and downloaded residents' favorite music. This produced great results," said Ms. McNamara. Another program involved the "Sunshine Group," where select residents participate in outdoor activities-such as picnic lunches with families-on a 60-acre property and indoor greenhouse. Elsewhere, Ms. McNamara and her team turned an unused room into a cinema, where residents and family members can watch favorite movies on an extra-large screen with surround sound. Additionally, they established a casino room with card tables and slot machines and a sensory room with a fish tank, scenic murals on the walls, comfortable furniture, and comforting items such as dolls and stuffed animals.
"We have had great success, and we're sustaining a 51% reduction in antipsychotics," said Ms. McNamara. She attributed the success to the variety of activities they've been able to offer and staff's ability to customize interventions according to each individual resident's needs and interests. To encourage staff and others to consistently think about person-centered care, the facility put "bio frames" on the door of each resident's room. "These provide a snapshot of what the patient was like before they came here. This has helped everyone see residents as individuals and determine what activities are most likely to comfort and interest them," she said.
"We were so thrilled to be recognized nationally for our work. We were pleased to have the opportunity to share our successes so they can be replicated around the country," Ms. McNamara said about winning the QI award. "By implementing a multi-faceted, personalized approach to behavioral management, we have given our residents a better quality of life and engaged families more. It's a wonderful feeling to share this with our peers and get their feedback."