59 * NATIONAL AUDIT OF DEMENTIA: PROGRESS REPORT

Abstract

Evidence-base: At any one time, a quarter of acute hospital beds are in use by people with dementia. Concerns have repeatedly been expressed about the quality of inpatient care that people with dementia receive. It is recommended that frail older people admitted to general hospitals receive a comprehensive assessment which focuses on their medical and psychological conditions and functional capacity as part of a holistic treatment approach.Change strategies: The National Audit of Dementia was established in 2008 to examine the quality of care received by people with dementia in general hospitals in England and Wales. Two rounds of audit took place in 2010 and 2012. Each collected data from 210 hospitals in England and Wales, (99% of Trusts and Health Boards in 2010 and 100% in 2012).Each hospital was required to audit 40 case notes of patients with a diagnosis or current history of dementia. Information on physical and mental health assessments recorded was collected. Hospitals were asked if they had a care pathway for dementia.Change Effects: Type of assessmentRound 1 (n = 7934)Round 2 (n = 7987)% case notesMobility8794Pressure sore8794Nutritional status7089Patient asked about continence needs8187Patient asked about any pain7687Mental status test (standardised test)4350Functioning (standardised instrument)2644All assessments723Round 1Round 2 % hospitalsCare pathway in place636Care pathway under development4451Conclusion: Results overall show improvements in physical health assessments, with room to improve further, particularly in assessment of functioning. Mental health assessment also requires improvement. Fully comprehensive assessment is not yet in place for the majority of people with dementia, and hospital care pathways are yet to be fully implemented in most hospitals.