Step Exhibitions
Ward 4: One Room with a Big Impact – NHS Forth Valley Royal Hospital
Nominee Information
In short, for a small budget we have created a room that has reduced violence, aggression and falls for one of the most vulnerable patient groups.
Ward 4 is a ward for inpatients primarily with advanced dementia who present with severe challenging behaviours, particularly aggression. Our patients are also frail and vulnerable to falls. Despite severe cognitive impairment, patients respond to their environment.
This entry is a modest project which had a budget of £150,000 to renovate three rooms, bringing two of them into the Ward’s footprint. This nomination covers only one of those rooms, the creation of a new sitting room.
We worked to obtain agreement to bring a large MDT room adjacent to Ward 4 into service for patient care. This project brought together a range of healthcare professionals, senior managers and the estates team. It drew on available evidence for design to minimise distress in our patient group, with a thoroughness that is uncommon for such a small project.
Ultimately, our design incorporated specific consideration of:
– Colour palette (to ensure maximal colour contrast to aid patients with impaired visual processing)
– Acoustic design (dementia patients struggle significantly with verbal communication)
– Improved access to television (a larger screen, less glare and access to programmes from the past to aid orientation).
– Reminiscence therapy. The room has a bespoke reminiscence cabinet populated with items familiar to patients from their younger years. There is ample storage for objects that patients can handle.
– Improved garden views, as a view of nature can improve wellbeing.
– More controllable lighting (softer, more controllable lighting can be of particular benefit to some).
One novel part of this project is our evaluation of the space using qualitative and quantitative measures to understand which elements have been most effective. We intend to use this learning in future developments in the Mental Health Unit.
Overall, the benefit has been considerable. Analysis of the incident report data showed a notable reduction in both falls and violence and aggression following the introduction of the new sitting room. Comparison of the two months post implementation (November 2024 – January 2025) with the same period in the previous year (November 2023- January 2024), showed a reduction of 38.1% in total incidents. Violence and aggression incidents reduced significantly by 62.5% (from 8 to 3), while falls (including two near misses) saw a reduction of 23.8% (13 to 10).
An evaluation of 15 staff members (Staff Nurses, Nursing Assistants, Occupational Therapists and Activity Coordinators) showed 100% agreed that the room improved the overall care environment and created a calm atmosphere. 71% agree that the design choices had a direct positive impact on patient behaviour, with 80% of staff believing it had reduced incidents of violence and aggression.
Furthermore, 87% of staff felt that the room also supported staff wellbeing and improved the staff confidence in managing patient behaviour.
