Meet Brianna Walpole, Cognition Clinical Lead at Monash Health.

What is your role at Monash Health and what does it entail?

I am the Monash Health Cognition Clinical Lead. My role involves helping to improve the care of patients with cognitive impairment across all our inpatient campuses. I do this via the Delirium and Dementia Initiative.

What is the Monash Health Delirium and Dementia Initiative?

The Initiative provides a framework for improved care of patients with dementia and delirium at Monash Health. It includes screening, diagnosis, management, follow-up and education for patients, families and staff.

If we recognise delirium early we can manage it better and ultimately improve the health outcomes of our patients as well as their experience. Screening for delirium uses the 4AT completed by nursing staff, diagnosis requires medical assessment to look for and treat underlying causes and management can be improved by using non-pharmacological strategies such as the Sunflower tool and TOP 5 to help communicate with the confused patient.

The Sunflower is used to collect information about the patient, including how they like to be addressed, what they enjoy doing, names of pets etc. Allied health are also engaged early on and may be involved in assessing cognition in more detail, mobilising the patient and so on. Caring for patients with delirium and dementia requires a whole team approach and very much involves the patient and their family!

I’m currently spending time on each ward implementing these new resources, as well as working with staff at the bedside to help with hands on education. I will be progressively working with ward champions who will become the local experts.

What has your journey been like at Monash Health?

I have been at Monash Health for nearly two years. Previously I worked as a clinical occupational therapist. I was particularly interested in the impact of impaired cognition and how that affects people and their families in their day to day activities and also when they become unwell and are admitted to hospital.

I was involved in developing some strategies in my previous position but remained frustrated that the care needs of confused patients were not a priority. My role here at Monash Health has provided me with a very exciting opportunity to make a difference. I’ve enjoyed getting to work on all campuses and am grateful for the enthusiasm that staff have shown, both in welcoming me and embracing the Delirium and Dementia Initiative.

What is one of the biggest challenges your team faces?

Continuing momentum and making the Delirium and Dementia Initiative sustainable. I am currently the only Cognition Clinical Lead and Monash Health is a very big organisation! It takes time and energy to create change and embed resources to change the way we have been caring for patients with cognitive impairment. I know we are definitely on the right track.

My hope now is to build on the current enthusiasm from everyone who can see the impact it has having. My hope in the future is that all our staff are skilled and resourced and no longer need me!

What is your biggest achievement at Monash Health?

Raising awareness through World Delirium Awareness Day- we have a 40% prevalence of delirium at Monash Health so it is everyone’s responsibility and I can see more and more people talking about it and getting involved.

Also presenting some of the great outcomes we have achieved at national and international conferences.

What is the most rewarding part of your role?

Seeing that what I’m doing makes a real difference. Getting positive feedback from staff, families and patients’ that things were that little bit easier.  For example, a patient was having difficulty walking. Staff found out his favourite music was Elvis from the Sunflower, so the Nurse and Physiotherapist played Elvis and his face lit up and he started to dance. He actually got home a lot sooner because he was got out of bed and mobilised because they found out something that was meaningful to him!

If you weren’t working in your current role what would you be doing?

I’d own a café with the best coffee and brunch in Melbourne. It would be dementia friendly so that everyone could enjoy it and I’d call it Therapy!

One thing about me that people probably don’t know is….

I have a twin brother! And it runs in my family so my Mum is a twin and has a twin brother and my Nan was a twin with a twin brother as well!