I had been working on developing the bundle for some time and had completed the literature search and worked with colleagues in the local Alzheimer's Society and Carers First and we had agreed our aims:
1. Swift identification of patients with dementia and delirium to enable appropriate prompt intervention and necessary referral or follow up after they leave hospital.
2. Knowing key information about patients who are unable to communicate this to enable a person centred care approach to care and communication that is frequent, skilful and compassionate.
3. Nutrition and hydration needs that are not only adequately identified and provided but are in line with patient preference and provided in a way that is tailored to their needs and capability.
4. A safe, caring and therapeutic environment is provided.
5. Family and carers are welcomed, involved and have their needs considered and supported
From these I then worked on the bundle itself; it is a prompt or an aide-memoire for the core considerations and interventions for every patient who presents with some level of confusion; it is not designed to replace current documentation or care planning - I needed it to be meaningful, intuitive and not to be seen as just another form to fill in.
After a number of iterations the bundle has been completed and I have a meeting in the diary with clinicians for early December to prepare a pilot phase.
We will use the PDSA 30, 60, 90 day model to rapid review with an aim to then cascade across the Trust.
There has been an energy and engagement with the bundle which is great to see and I am excited to see it come to fruition.