One of our specialist older adult units explores the idea of uniforms in preperation for introducing them to one of our female dementia units.
In one of our monthly staff meeting a number of staff had asked about the possibility of uniforms, this is something that had been suggested a number of years ago but it was decided that the change would not be made at the request of family and patients at that time. I was interested to see why staff wanted uniforms and what impact they thought it would have on the unit, for example having uniforms to protect your personal clothing is no basis for such a big change on the ward with potential impacts on our patients. There are also considerations around giving an institutional feel and creating a patient/ staff hierarchy.
From this I made up a simple poll on the unit to try and gather the information I felt we needed form the team. The poll was unanimously in favour of the uniform and staff gave numerous reasons for wearing a uniform and clearly understood the possible implications and potential benefits for the ward. The reasons included easy identification of staff for dementia patients, possible reduction in patient on patient altercation, relatives able to recognise staff and infection control benefits. The staff team had clearly looked into the uniform and they came up with some valid and well though out reasons for the use of the uniform.
The most important part of the process was to ask patients on the unit there thoughts. We asked patients on an individual basis due to differing levels of cognition and communication difficulties. The results where again unanimous, in the favour of staff wearing a uniform. Patients felt they would be better able to recognise staff and that the ward would look much smarter. Carers and relatives where also provided with a questionnaire in which they where asked if they would like to see uniforms or not, and provided with the opportunity to give feedback on their decision. Answers arrived back with an obvious preference towards uniforms. The answers provided by families where much the same as those given by staff and patients.
The decision was pretty much made for us at the point form feedback received and, the only challenge remained was to chose the uniform itself. We had to ensure this was practical, appropriate to use and evidence based. We looked into the use of uniform within dementia setting as well as to look at the use of colour with dementia patients, something which we use as course on Katherine Allen. We needed the uniform to be practical for daily tasks such as lifting and personal cares, we needed it to stand out for our patients and family but, we needed to make sure that it did not give out an institutional feel to avoid uneven relationships and power imbalance. We decided that the uniform should be a non traditional colour, and a bright colour. We looked into what colours would be suitable to the patient group and after much discussion and research we decided on the colour red.
Red is a stimulating colour within dementia care, It is a colour that people retain even in very late stage dementia and a colour which we often use on the ward to enable patients to recognise objects such as cups, plates and signage. We thought that the colour would help patients recognise staff, stimulate appetite and increase activity. We needed the uniform to do what we set out to do and reduce patient anxiety and patient on patient altercation and so, the colour red was decided upon amongst the team and patient group. The decision was taken to the senior management team and costings where provided. This was agreed upon and the uniform is currently on order.
We are attempting to create some outcome measures for the uniform and intend to complete some research over a 12 week period. We are looking into specific areas such as reduction in altercations, compliance with aspects of physical care and staff feelings of well being. The uniform will be reviewed on a regular basis and our findings, positive and negative, will be provided throughout the Retreat and beyond.