RPA ED Patient Wellbeing Trolley

December 2020

Wellbeing Trolley trialled in RPA's Emergency Department

A new Wellbeing Trolley, stocked with games, puzzles, art supplies, music and homemade fiddle mitts, is making a visit to RPA’s Emergency Department (ED) less stressful, particularly for the elderly and mental health patients.

“I think it’s excellent. I’ve got something to do. It pre-occupies me because I’m worrying about what’s going to happen next,” said Sandra O’Keefe, as she focused on a word game while lying in her hospital bed in the ED.

Doctors, nurses and allied health workers were inspired to introduce the trolley because of the rise in the number of people over the age of 65 presenting at hospital EDs – many of whom are affected by the unfamiliar environment.

“EDs are noisy, chaotic and busy places. Sometimes, elderly patients become confused and disorientated,” Dr Sinéad Ní Bhraonáin, an Emergency Medicine Consultant at RPA, said.

“In elderly patients with dementia, their frustrations with communication, loneliness, anxiety or pain may be expressed as agitation, wandering, frequent requests for help and calling out,” Dr Ní Bhraonáin said.

It’s hoped the trial of the Wellbeing Trolley will help to alleviate these behavioural and psychological symptoms of dementia (BPSD) that patients may experience in the ED.

“Evidence shows that providing therapeutic activities can reduce BPSD and improve a patient’s mood and ability to function as well as their behaviour,” Dr Ní Bhraonáin said.

The trolley includes activities that target patients’ emotional wellbeing, cognitive integration, fine motor skills, vision and offers sensory stimulation.

Armed with $10,000 in funding, the team sought expert advice about the items to add to the Trolley, with clinicians from the Mayo Clinic in Rochester, Minnesota and Saint Vincent’s Hospital in Dublin also sharing details about their wellbeing trollies.

A volunteer at RPA, Loris Perryman, handmade sensory interactive activity mitts, aprons and blankets, which have zips, ribbons, buckles and textured materials sewn on them, for the Trolley.

Music, audiobooks and meditation exercises have also been uploaded onto a donated IPod for elderly and mental health patients to enjoy.

“I created a playlist of tunes, based on the songs I remember my father loved –  by Dean Martin, Johnny Mathis, Perry Como, Ella Fitzgerald, Nat King Cole, Bing Crosby and Frank Sinatra,” Dr Dane Chalkley, a senior staff specialist in Emergency Medicine, said.

“The list is called ‘Goldies and Oldies’, and in many ways describes the patients we’re helping in the ED. It’s been used a few times now and quite successfully,” he said.

The Trolley also includes coloured pencils, crayons and pens; writing, sketch and activity books; crossword, Sudoku, and word search puzzles plus stickers, squishy balls, soft toys, playing cards, a kaleidoscope and a magnifying glass.

There are also personal care items including pre-pasted toothbrushes, paw paw ointment, hair ties, hand cream, hair combs, face masks and reading glasses. Many of the items are single-use products or will be kept by the patient when they’re transferred to a ward.

“We hope the Trolley will contribute to creating a calmer environment in the ED, provide patients with a distraction and bring some comfort to them,” Colleen James, a Clinical Nurse Consultant with RPA’s Aged Services in Emergency Team, said.

There are also benefits for mental health patients too.

“There’s a growing recognition of the need to provide more than clinical treatment in EDs. For mental health patients, there’s been an increase in the use of sensory tools to help people self-soothe,” Associate Professor Tim Wand, a Nurse Practitioner in Mental Health at RPA’s ED, said.

There are already plans to trial a Wellbeing Trolley aimed at children in the ED and inpatients in the Paediatric Ward.