Aim(s): To evaluate the feasibility and acceptability of a ward-based Behaviour Support Plan (BSP) protocol for improving management of changed behaviours in hospital patients with dementia and/or delirium.
Design: A mixed-methods cross-sectional hybrid type 3 effectiveness–implementation study underpinned by a federated model of social learning theory and Normalisation Process Theory.
Methods: Data were collected over five months on a 20-bed medical ward in a regional Australian hospital between December 2024 and May 2025. Implementation outcomes were assessed using fortnightly bedside audits of person-centred bundle-of-care items, pre–post staff questionnaires, and two multidisciplinary focus groups. Quantitative analysis included descriptive statistics, regression modelling and non-parametric tests. Qualitative analysis involved the Framework Approach—a type of codebook thematic analysis.
Results: The protocol was feasible and acceptable, with staff demonstrating strong engagement and positive perceptions of its value. Bedside audits revealed statistically significant increase in biographies and environmental modifications (OR 1.13) alongside pain assessment (OR 1.26). Pre–post questionnaires indicated strengthened collective action (3.63, 95% CI 1.35–5.91) and greater integration of the protocol into routine practice. Focus groups highlighted the BSP’s clinical utility, brevity and effectiveness in guiding therapeutic responses, improving clinical reasoning and multidisciplinary communication. Staff also reported reduced pharmacological sedation and more person-centred behavioural de-escalations.
Conclusion: The BSP protocol supported meaningful practice change, improving delivery of person-centred behavioural care within existing ward resources. Early interprofessional formulation and structured care planning were valued by staff and demonstrated potential to enhance care quality and safety for hospitalised people with dementia and/or delirium.