Background The Royal Voluntary Service (formerly known as the Women’s Royal Voluntary Service) on-ward volunteer initiative was launched within Sheffield Teaching Hospitals NHS Foundation Trust (STHFT) in November 2011. The purpose of the initiative is to improve the inpatient experience of patients with dementia by using on-ward volunteers recruited and trained by the Royal Voluntary Service (RVS) supported by a Dementia Nurse Specialist (DNS) employed by the Trust.
It is envisaged that the on-ward volunteer service (OWVS) volunteers will provide support through a number of activities including befriending, diversional therapy, companionship, reading, support with eating and drinking and supervised mobility and recreational visits within the hospital as well as supporting carers and providing respite time. The OWVS aims to complement the care provided by Trust staff. The recruitment of volunteers will be the responsibility of the RVS, who will also provide and fund a training programme for the volunteers and will manage the OWVS within the Sheffield RVS hub. However, STHFT have appointed a Dementia Nurse Specialist whose role within the on-ward volunteer service initiative will be to direct the volunteers to work with patients and families in the most appropriate way.
The OWVS initiative has been established in the first instance as a pilot project, for a period of 12 months based on an orthopaedic ward at STHFT which has a high incidence of patients with dementia who are recovering from surgery e.g. following fractured hip.
Through a partnership between the Trust, Sheffield Hallam University and the Translating Knowledge into Action (TK2A) theme of NIHR CLAHRC for South Yorkshire, an opportunity now exists to evaluate the OWVS initiative from a number of different perspectives. The evaluation started in November 2011 and was completed in December 2012. Aims The aim of this project is to evaluate the impact of the on-ward volunteer service initiative at the Sheffield Teaching Hospitals NHS Foundation Trust. More specifically, the objectives are:
To describe the care provided by the OWVS volunteers to patients and carers.
To describe the activities of the Dementia Nurse Specialist in relation to the OWVS volunteers.
To explore the perceptions of key stakeholders on the potential of the OWVS initiative to improve the inpatient experience for people with dementia and their carers.
To explore the perceptions of ward staff on the impact of the OWVS initiative on the delivery of care and on the experience of patients and carers.
To explore the perceptions of OWVS volunteers in relation to their preparation for their role and their experiences in practice.
To explore the perceptions of carers on the value of OWVS initiative.
To identify factors which act as barriers and facilitators to the success of the OWVS initiative.
To capture changes in relevant Nurse Sensitive Indicators since the introduction of the OVWS initiative.
Evaluation approach This is a mixed methods service evaluation which uses a range of different approaches to data collection.
Stage 1 A qualitative consultation to explore the perceptions of key stakeholders Interviews with key stakeholders from STHFT and the RVS will be undertaken at the start of the evaluation with additional follow up interviews with the Dementia Nurse Specialist and RVS Service Co-ordinator towards the end of the evaluation. The participants' perspectives on the value of the OWVS in contributing to the improvement of care at ward level and any additional benefits the initiative will bring to their own organisations or personal objectives will be sought. Interviews will also cover their perceptions on factors which may help or hinder the initiative in practice.
Stage 2 Mapping the activities of the OWVS volunteers and the Dementia Nurse Specialist (DNS) It is anticipated that the evaluation team will work with the Dementia Nurse Specialist (DNS) and the RVS in order to establish a system to monitor and capture the activities of the OWVS volunteers. This is likely to include a variety of approaches such as monitoring the volunteer rotas or devising simple proformas to recording the amount and type of care given to patients by the volunteers.
Stage 3 Mapping the recruitment and turnover of OWVS volunteers It is anticipated that the evaluation team will work with the RVS Service Co-ordinator in order to capture information on the recruitment and turnover of OWVS volunteers in order to provide information on reasons for volunteering, numbers recruited and trained, turnover and reasons for leaving. This is likely to include a variety of approaches such as collection of routine data and devising simple 'entry' and 'exit questionnaires' to recording reasons for starting and leaving.
Stage 4 A qualitative consultation to explore the perceptions of OWVS volunteers over time Focus group discussions will be held with a convenience sample of OWVS volunteers, at the beginning, middle and end of the pilot stage. The participants' perspectives on the preparation they received, the extent to which they felt prepared for working with patients and carers and the extent to which they feel supported in practice will be sought. Interviews will also seek to capture the extent to which they feel the OWVS makes a difference in practice will also be sought as well as their views on barriers and facilitators to the success of the initiative.
Stage 5 Observation of practice In order to gain insights into the work undertaken by the OWVS volunteers and the impact on patients, carers and ward staff, members of the evaluation team will undertake short periods of non-participant observation in the ward area at the beginning, middle and end of the pilot period. This will include observing the care of patients with dementia and their families at different times of the day.
Stage 6 Focused conversations with ward staff Purposive sampling will be used to select stakeholders who are able to provide insights into the impact of the OVWS on patient care. Data collection will consist of short focused conversations with staff following which detailed notes will be made.
Stage 7 Analysis of routine data It is anticipated that the evaluation team will work with the Deputy Chief Nurse to extract routine data at ward level before and during the pilot period for the following Nurse Sensitive Indicators linked to the Patient Safety Thermometer: