Dr Sinéad Ní Bhraonáin 
Australia 

In Sydney Local Health District, we recognise that coming to an Emergency Department is challenging. People feel unwell and vulnerable. It is a noisy chaotic environment. As a result of this, we set up a distraction trolley for patients coming into our department to try and improve their patient experience and reduce their distress.

The aim of the trolley is primarily to reduce the behavioural and psychological symptoms of dementia for elderly patients presenting to the department. We have also included mental health as part of the trolley. As we know, mental health patients can spend prolonged periods in the ED which is distressing and incredibly boring for them. We hope through the trolley to provide a form of distraction therapy for all patients coming to the Emergency Department. Since the roll out of the trolley, we have also set up a second trolley for paediatric patients.

PACMAN stands for:

P– Psychosocial
A– Activity
C– Comfort
M– Mental Health
A– Activity
N– Nurture

Our committee is a multidisciplinary team involving Emergency Medicine, Paediatrics, Mental Health, Aged Care, Dementia team and also the volunteers. Together we performed a literature search looking at the best evidence to improve the patient experience. We divided the trolley into six areas: Sensory, Visual, Motor, Cognitive, Psychosocial and Personal Care.

Items in the trolley include:

Fiddle mitts, activity aprons, puzzles, colouring books, hearing aid batteries, headphones for a silent disco, reading glasses, magnifying glasses, jumbo playing cards, hand cream, combs, tooth brushes, face and eye masks and lots more!

As part of the trolley, we will also do a wellbeing brief with our Emergency department medical, nursing, aged care and mental health team every morning to identify the needs of the department/ suitable patients.

We hope to improve the patient experience for all patients coming into our Emergency Department. We aim to reduce the risk of deconditioning and hospital acquired functional decline for our elderly patients at the beginning of their hospital stay (#EndPjParalysis). We also hope to minimise any distress by using distractions for our adult and paediatric patients regardless of their presenting complaint.

We put together a video to outline our experience with the PACMAN trolley. We hope you enjoy it!

Watch Video