The Mid North Coast Local Health District is raising awareness about the use of TOP 5 for people with cognitive or communication problems.
TOP 5 is a simple tool that is used to collect knowledge from carers. This information can assist LHD staff to support patients during their admission and deliver personalised care.
Carers simply fill out a form, providing information to staff on what the patient does and doesn’t like. This helps to ensure the patient is more comfortable and settled during a hospital stay, or while they are being cared for by community health staff.
The TOP 5 form is available via the Mid North Coast Local Health District’s website.
TOP 5 has proven benefits in the reduction of falls and the use of anti-psychotic medications, as well as greater engagement with carers. The Clinical Excellence Commission’s TOP 5 research project showed 88.5% of carer respondents agreed that TOP 5 had facilitated their own engagement in care. Staff also benefit from this simple tool as they have a happier, more settled patient to care for.
- A patient was admitted to Coffs Harbour Health Campus for an elective surgical procedure. He had a history of vascular dementia and lived at home with his wife who was his carer.
- Due to his cardiac comorbidities, the patient was transferred to Coronary Care post operatively where he experienced significant behavioural and psychological symptoms of dementia.
- Once stabilised, he was transferred to the Surgical Ward. During his recovery in hospital he experienced further decline in his physical and cognitive condition and was transferred to the Medical Ward, where he awaited placement in a Residential Aged Care Facility.
- Early in his admission nursing staff talked with his carer and obtained information that was used to personalise his care. The TOP 5 strategies were listed, which helped manage the behavioural and psychological symptoms associated with his dementia.
- When the patient was transferred to another ward, the TOP 5 strategies to support care and communication went with him.
- On the day of discharge, paperwork was being completed for a transfer to the Residential Aged Care Facility and the discharge planner gave the TOP 5 form to the escort nurse to have with her during transport.
- The escort nurse gave feedback that the gentleman did become agitated and unsettled during transport. The nurse was able to use the strategies on the form to communicate with the patient and settle him. On arrival to the facility the escort nurse handed over the TOP 5 strategies, which then helped the new nursing staff to care and communicate with the patient in his new environment.
- The TOP 5 strategies followed this patient’s journey, ensuring that staff had knowledge about the patient and could personalise his care and use the strategies to help calm him.
The simplicity of the TOP 5 tool belies its effectiveness. Everyone is encouraged to use the tool across different groups of patients. People with dementia are clearly a core group, but TOP 5 can also be useful for people with mental health issues, or brain injuries that cause communication issues, or people with an intellectual disability.