2017 Research and EBP projects
Achieving Pain Management with Less Opioids
Effects of a Reorganization on Nurses and Patient Outcomes
Happy Hour, Anyone? Innovation to Person-centered care
Authors: Heather Roorda MSN, RN-BC & Mae Dizon DNP, RN, NP, ANP-B
PICO/Clinical Question: Will the implementation of a 1 hour structured activity program for adult inpatients on a medical surgical unit help to define appropriate participants and demonstrate feasibility and usefulness to improve patient care?”
Project Goal: To evaluate the feasibility of implementing an activity room in the acute care setting medical unit and examine patient and staff receptiveness to the creation of a structured activity room that creates a therapeutic environment for patients in collaboration with other resources in the acute care setting.
Background: After attendance at the 2016 NICHE Conference, the concept of “Activity Room Sessions” was brought back by attendees for implementation. Literature review indicated that participation in social and leisure activity was found to have an effect on the well-being of older adults (Adams, Leibbrandt, & Moon, 2011). Huxhold, Miche, Shϋz (2014) surveyed older adults who participated in social activities and they reported increased positive affect and life satisfaction. Activities such as music listening (Skingley & Vella-Burrows, 2010; Bottiroli, Rosi, Russo, Vecchi, & Cavallini, 2014), playing cards (Waszynski et al., 2013), and painting (Waszynski et al., 2013) resulted in decreased agitation and improved cognitive performance. The evidence was predominately for outpatient settings. Providing these types of activities has not been a focus of acute care settings. However, with an aging population and a push for a more therapeutic milieu, creation of an activity room could be valuable for hospitals and was the motivation for this EBP project.
Methodology: A pre-implementation survey was sent to staff to gather ideas around the program’s name, suggested activities, and process flow. Based on the survey, the initiative was named Happy Hour and it became a one-hour, weekly session coordinated by a nurse practitioner and educator. The program also involved nursing students, rehabilitation services, and GRNs. Inclusion criteria to establish patients who could safely attend was defined as well as appropriate activities. A follow-up survey was sent 3 months after implementation. Questions revolved around the current process, experiences, patient feedback, and whether staff had any suggestions for future activities.
Results: 265 patient were approached. 110 participated. 81 were older adults. 30 had primary or secondary diagnosis of delirium or dementia. Staff responses indicated 81% had referred a patient to Happy Hour. 67% reported that his/her patient had a positive experience. Overall, staff have responded positively to having a weekly activity room.
Conclusions: More than a year into implementation, staff remained positive and engaged about the initiative. Creation of an activity room is a novel approach to enhance patient experience, promote patient engagement, and assist nursing staff in allowing for meaningful activities that can support patient healing and recovery. Implementing a structured activity room in a busy acute care unit is feasible by collaborating with staff and involving existing resources. To minimize the cost of the initiative, donations and grants were sought. All these steps resulted to the sustainability of the activity room. Future steps of the project include submission to the IRB to evaluate specific patient outcomes.