Evaluation of a Staff Dementia Patient Agitation Training

Abstract

Problem Statement: Psychological and behavioral issues are seen in the majority of patients with dementia. Certified nursing assistants (CNA) at long-term care facilities regularly encounter these agitated behaviors, however they are often not equipped with the necessary training needed to respond and prevent these behaviors. Purpose: To evaluate a dementia agitation training program for CNAs and its impact on patient agitation at Hale Kuike Pali. Methods: Two dementia education modules were developed, covering topics on how to make positive connections with dementia patients, how to overcome communication challenges, and techniques on how to respond to agitated episodes. Training was provided to staff over a one-month period. Patient agitation was assessed by the Director of Nursing pre- and post-training using the Pittsburgh Agitation Scale (PAS) to evaluate the training program for staff. Results: Of the 25 CNAs at Hale Kuike Pali, 23 completed the dementia training program (92%). After the staff training was completed, the pre- and post-staff training PAS scores were compared. No changes were seen in aberrant vocalizations; percentage changes in mean scores were a 33% decrease in motor agitation (1.8-1.2), a 27% increase in aggressiveness (1.1-1.4), and a 7.7% increase in resisting care (1.3-1.4). Discussion: The dementia education training program showed promising results in reducing motor agitation, however, decreases in aberrant vocalizations, aggressiveness, and resisting care were not found. This could be due to several confounders or biases related to type of measurement tool, project design, and sample size. For future projects, ongoing refresher training programs and selection of a measurement tool that evaluates patient behavior over an extended amount of time are recommended.