Testing the sensitivity of two dementia knowledge instruments in dementia workforce education.

BACKGROUND: The importance of dementia education in improving the care and support that people living with dementia is well established. Previous research has shown ceiling effects in pre and post educational intervention measures of dementia knowledge using Knowledge in Dementia Scale (KIDE) on post-registered health and social care staff in Scotland. The aim was to test the sensitivity of two dementia knowledge instruments, namely the (KIDE) and the Dementia Knowledge Assessment Scale (DKAS). DESIGN: A pre and post evaluation comparison of two dementia knowledge scales. SETTING: The tenth cohort of Scotland's National Dementia Champions Education Programme, September 2019-March 2020. PARTICIPANTS: Post-registered Health and Social Care staff (n = 117). METHODS: Both the DKAS and KIDE scales were administered pre and post programme delivery. Wilcoxon signed-rank tests were performed to examine T1 - T2 differences in dementia knowledge for both validated measures. RESULTS: Ceiling effects continued to be present for the KIDE scale at T1 and T2. The DKAS responses showed a different score distribution than that achieved by the KIDE. Ceiling effects noted for KIDE at T1 were not present for the DKAS. Further, at T2, only 6% of respondents scored the maximum on the DKAS. CONCLUSIONS: The DKAS appears to be a more useful instrument for measuring knowledge in post-registered health and social care staff; however, there was some evidence of ceiling effects post-intervention. There is a need for both scales to be tested in more educationally diverse populations, so educators and researchers can make informed decisions about the instrument's target range. Additionally, further research is needed to develop new sets of dementia knowledge items suitable for use in trained health and social care staff.

Poor care and the professional duty of the registered nurse.

Concerns have been raised in recent years about standards of care in the UK. Notable failures have been identified in the care of vulnerable older adults. This article identifies and discusses some logical steps which might be taken to minimise the risk of individual and systemic care failure in settings for older adults. These steps include frank discussion about ageism to promote empowerment and respect for older people; ensuring robust policies are in place that support and encourage the reporting of poor care; and ensuring that registered practitioners are aware of their accountability for their actions and also their omissions should they witness poor care. In addition to reducing the risk of poor care, these steps could contribute to having a more confident, competent and empowered workforce.