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Atrium Health Navicent

Presentation Notes

Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.

Abstract

Background

Hospital admissions for neurodegenerative diseases like dementia and Alzheimer's, along with neuropsychiatric symptoms (NSS), are increasing. Patients with NSS are 4-5 times more likely to fall and sustain serious injuries, impacting patient experience and causing financial strain on the organization. Current interventions to reduce the challenging NSS include psychotropic medications, which can cause further adverse effects. Therefore, non-pharmacological interventions are considered an important 1st line treatment to lessen challenging behaviors.

Local problem

At this facility, over 50% of elderly patients who fall out of bed have confusion, accounting for 20% of our 500 falls per year. The purpose of this quality improvement was to reduce falls in patients with NSS such as agitation, wandering, and confusion.

Method

The PDSA cycle a problem-solving methodology for testing and implementing changes, guided this project. An interdisciplinary team that included clinical nurses with neurodegenerative disease experience recommended Doll Therapy (DT). Literature supports DT as a nurse-driven, patient-centered method to reduce challenging behaviors by promoting attachment and companionship. The team collaborated with an external consultant for baby dolls and educated staff. A DT manual was available on the units for procedural information.

Results/Conclusions

Data was collected via paper forms and EPIC. Forty patients received dolls during the pilot, with completed data for 29 patients. Average age was 75 years, 68% female and 32% male. Restraints, safety sitters, and psychotropic medication were discontinued. Seven patients fell before DT, with no falls after DT. There was a 77% reduction in NSS. DT improved quality of life for patients and their families. Family members felt less distressed as their loved ones were calmer and had better social interactions.

Implications for Practice

Doll Therapy is a non-pharmacological method to reducing NSS and falls. This pilot project showed DT's effectiveness in acute care settings and is being expanded to seven more units.

Document Type

Poster

Publication Date

11-12-2025


 

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Nov 12th, 12:00 AM

Using Doll Therapy to Reduce Falls in Patients with Neurodegenerative Diseases in an Acute Care Setting

Background

Hospital admissions for neurodegenerative diseases like dementia and Alzheimer's, along with neuropsychiatric symptoms (NSS), are increasing. Patients with NSS are 4-5 times more likely to fall and sustain serious injuries, impacting patient experience and causing financial strain on the organization. Current interventions to reduce the challenging NSS include psychotropic medications, which can cause further adverse effects. Therefore, non-pharmacological interventions are considered an important 1st line treatment to lessen challenging behaviors.

Local problem

At this facility, over 50% of elderly patients who fall out of bed have confusion, accounting for 20% of our 500 falls per year. The purpose of this quality improvement was to reduce falls in patients with NSS such as agitation, wandering, and confusion.

Method

The PDSA cycle a problem-solving methodology for testing and implementing changes, guided this project. An interdisciplinary team that included clinical nurses with neurodegenerative disease experience recommended Doll Therapy (DT). Literature supports DT as a nurse-driven, patient-centered method to reduce challenging behaviors by promoting attachment and companionship. The team collaborated with an external consultant for baby dolls and educated staff. A DT manual was available on the units for procedural information.

Results/Conclusions

Data was collected via paper forms and EPIC. Forty patients received dolls during the pilot, with completed data for 29 patients. Average age was 75 years, 68% female and 32% male. Restraints, safety sitters, and psychotropic medication were discontinued. Seven patients fell before DT, with no falls after DT. There was a 77% reduction in NSS. DT improved quality of life for patients and their families. Family members felt less distressed as their loved ones were calmer and had better social interactions.

Implications for Practice

Doll Therapy is a non-pharmacological method to reducing NSS and falls. This pilot project showed DT's effectiveness in acute care settings and is being expanded to seven more units.

 

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