Jean Marcos Singh of Brazil, Michael Drake of USA, Silvija Sutkutė of Lithuania, Stephan Wengel of Germany, Julia Osiecka of Poland, Markus Suominen of Finland and Caroline Bjarnevi of Sweden are the winners of the Queen Silvia Nursing Award 2021.

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The Queen Silvia Nursing Award is an annual award for nurses and nursing students to submit ideas and innovations to improve patient care for older people and people living with dementia.

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The Queen Silvia Nursing Award was established by Swedish Care International and the Forum For Elderly Care in 2012 as a gift to Her Majesty Queen Silvia of Sweden in honor of the Queen’s many years of advocacy for better elderly and dementia care, as well as increased competence of dementia diseases within healthcare teams.  Her Majesty was a caregiver to Her mother who was diagnosed with dementia in the later years. Her Majesty offers to patronage to other dementia awareness projects such as Dementia Forum X and Stiftelsen Silviahemmet

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The Winning Ideas

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“Digital Support for Oncology Patients” – Jean Marcos Singh, Nurse at Wecancer online clinic in Brazil.

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Jean’s idea proposes the development of a remote assistance service available via web or app which connects healthcare teams with cancer patients throughout their journey against the disease.

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Brazil has a population for 14 million individuals over 65 years of age and this number is estimated to reach 39 million by 2040. Cancer incidences are approximately 11 times higher in individuals over 65 years of age than in younger people. 70% of cancer-related deaths also occur within the 65+ age group. The increase of cancer diseases in the elderly causes a higher rate of hospitalization, mental distress and other complications, thus generating an increase in costs and decreased quality of life for both patient and family.

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Jean’s idea could minimize risks due to prolonged hospitalization; avoid unnecessary visits to emergency services; improve cancer treatment adherence rates; and ultimately increase the quality of life and survival rates of cancer patients through navigation and care with specialized nursing teams.

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”QRx – a platform-agnostic, patient-centered care coordination and transition service” – Michael Drake, Program Assistant Nurse at the University of Washington School of Nursing Dementia and Palliative Education Network (DPEN)

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Michael’s idea – QRx – is a safe, secure, easy-to-use mobile platform that patients use to share important information to providers and/or caregivers via an individualized QR code that can be scanned from any device. With QRx, patients can manage, coordinate, and transition their care to whomever they like, wherever they are, and whenever they need it.

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Michael states, “Patients with dementia and their caregivers require good care organization and transition management. However, traditional electronic healthcare systems are not designed for ease of use and accessibility; they are often the problem – not the solution.”

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QRx was deemed as the most meritorious of all 2021 submissions received by Main Partner University of Washington School of Nursing. According to Dr. Tatiana Sadak, “QRx is innovative, well-developed and on its way towards implementation. Most importantly it is centered on empowering people living with dementia and their care partners to have vital health information that is updated and easily accessible.”

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“BusyOLDER” – Silvija Sutkutė, Nurse at LSMU Kauno Klinikos in Lithuania

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Silvija’s idea is the development of the “BusyOLDER” mobile app. It would allow older and disabled people an opportunity to order a variety of support activities to their home. The app would unite people who need help with people who are willing to lend a helping hand. “BusyOLDER” could help vulnerable populations decrease feelings of loneliness and isolation.

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The activities that can be arranged could be quite varied: from booking a time to chat to taking a walk together; baking a cake or running errands. Recipients may also offer activities in efforts to feel needed and have purpose. Providers may choose whether to receive payment for their services or not.

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“Working in a hospital with older people we see how much they need not only physical help, but also mental support. Older or disabled patients may experience extreme loneliness as they might not have many family members left, and their friends might have already passed away. Having someone close may have a miraculous impact. Therefore, in our hospital we try to attract not only personnel with big hearts, but also invite volunteers. When you have someone to lean on, you have less time for sad thoughts. We believe Silvija’s idea may offer significant change to lonely older people. And we are very honored to be a part of a project which aims to address such challenges”, said Kristina Judinė, Managing Director of Lithuanian Main Partner Addere Care.

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”Sweet Nutrient Booster for People Living with Dementia” – Stephan Wengel, Nurse at Klinik für Alterpsychiatrie und Psychotherapie ZFP-Emmendingen in Germany

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It is not uncommon for dementia patients to forget to eat meals. The reasons could be cognitive, affective or due to motor issues. Because of these missed meals, the lack of nutrients could accelerate the progression of dementia.

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This is where Stephan’s innovation of a Sweet Nutrient Booster comes into play. Stephan’s recipe is a sweetened nutrient complex bound with gelatin in a fruity, jelly-like form. They taste and look appealing and may be offered freely for patients who may be missing meals. The colors, flavors and shapes encourage snacking thus promoting regular nutrient absorption.

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Says Ulrich Zerhusen, Managing Director of Germany Main Partner St. Anna-Stift Kroge, "Stephan’s innovation in the dietary supplement space for dementia patients is unparalleled.  By combining nutritional grade dietary supplementation and the sweet flavor dementia patients prefer into a red gummi form easily and happily eaten, Stephan has changed the way caregivers can provide and monitor nutritional needs. This forward-thinking idea targets the basic dietary needs that are often difficult to provide for dementia patients in an intelligent, thoughtful and delicious way.  We are excited and inspired by Stephan and his idea to revolutionize dementia care through nutrition."

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”A Trip Down the Memory Lane” – Julia Osiecka, Nursing Student at Warszawski Uniwersytet Medyczny in Poland

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Julia’s idea, “A Trip Down the Memory Lane” proposes the research of utilizing virtual reality (VR) technology to enable seniors to re-experience activities they did in their past, in hopes to stimulate positive emotions and memories.

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Julia wants to explore how technology can evoke emotions and feelings from a senior’s younger years. Older patients can be introduced to the world of virtual reality and observed to better understand how they benefit from such exposure. Julia would like to examine how this affects a patient’s psychomotor condition, and how it may improve the quality of their health. By leveraging VR on a subconscious level, it may also stimulate conscious actions.

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“Julia's idea is an innovative and visionary project that can help overcome the limitations of dependent people. Julia impressed the members of the QSNA Selection Board with her speech, her clear vision of how to realise her idea, and her charisma. She convinced us that future technologies can help us return to the past – back to the times when we weren’t constrained, and all our dreams were within reach. Julia is involved in work for the community and has interesting passions and interests. Like the Queen Silvia Nursing Award project itself, Julia shows us that nursing can be a challenging, innovative and forward-thinking profession,” says Marcin Radziwiłł, President of the Medicover Foundation, Main Partner in Poland.

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“Transparent Reporting Portal” – Markus Suominen, Paramedic Student at Turun ammattikorkeakoulu in Finland

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Markus’ winning idea allows healthcare professionals to quickly and easily report their workplace grievances - such as understaffing, harrassment or heavy workload - transparently while respecting personal information and anonymity.

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Markus is convinced that better working conditionswould provide older people and people living with dementia access to evenbetter care. Healthcare professionals can provide better, less rushed, and morepersonal care if they are content with their working environment.

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The Finnish Jury was convinced of Markus’ dedication to this idea as he had already brought it to his local university hospital and healthcare district – both of which have expressed interest in the project. The combination of Markus’ concept, commitment to improving workplace conditions for better patient outcomes, and interest in growing the attractiveness of the nursing profession ultimately motivated the Finnish jury to award this year’s honor to Markus.

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”Memory book with music” – Caroline Bjarnevi, Nursing Student at Röda Korsets Högskola in Sweden

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"Memory book with music" is a classic hand-held book that can be personalised with photographs and audio recordings to stimulate memories for people who may be isolated or living with dementia.

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These books are currently available for children. As a children’s book the pages are filled with illustrations and text; and along the side of the book there are buttons that play audio recordings offering narration or musical clips. Caroline suggests that these books are personalized for older recipients instead. The pages could contain favorite photos and images from the past, while the audio recordings could be personalized with the narration of a  memorable occasion, messages of encouragement and good will from loved ones, or even favorite music songs.

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The Swedish Jury were moved by this Caroline’s idea as it gives caregivers a hands-on opportunity to become involved in creating a tool for their loved ones living with a dementia diagnosis. There are a multitude of benefits in the creation of a physical book that contains not only images but also audio recordings explicitly made for the patient in mind. This personalized book may inspire positive memories, reduce anxiety or worry, and bridge any feelings of isolation through the voices, stories and music from loved ones.

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My mother-in-law, living with both dementia and Parkinson's disease, murmurs, "I forget" quite often. What if dementia patients had a software app addressing the memory loss, isolation from family and friends during COVID-19, and the need for mental stimulation? What if this app also included all of their current medical and self-care needs as well as current caregivers and daily schedule? The app would also contain some of the patients life prior to memory loss.

My idea is ”Wait! I Remember!” -a three-part software app for tablets.

Part one: compilation of patient information, including appointments, self-care, medications, and allergies.

Part two: descriptions of caregivers, doctors, family/friends, personal history of the patient with photos and videos.

Part three: matching games from Part two content. Friends and family could upload photos, stories, and videos to be posted and cataloged on Part two.

When a dementia patient poses a question, the caregiver refers the patient to the app to and the answer.

The overall goal being patient engagement and reducing caregiver fatigue. During COVID-19, the app would help bring family and friends into the patient's world virtually keeping all of us safe. At the same time, the patient could play matching games that reflect their current life but also past memories.

Family could upload funny stories, pictures of grandkids or previous pets and the patient could match those pictures with names to stimulate brain activity and reduce the isolation of COVID-19.

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Antibiotic infusions are being prescribed more frequently during the COVID-19 pandemic. My idea is to improve the process for the preparation of antibiotic infusions so more time may be spent on patient care.

Today, these infusions are often in the form of a powder that must be dissolved in solvents. I suggest the creation of a sterile bar that can be inserted into the solution in efforts to mix it safely and quickly.

I developed a mechanism in the transfer cannula that allows the sterile stirring bar to drop into the solution without coming into contact with the outside environment.

I noticed during my rotation in gerontology and vascular surgery that nursing teams frequently had difficulties dissolving the powder into the solvent. This is made even more challenging because antibiotics are not to be shaken so to avoid small air bubbles.

In alleviating and easing the process of mixing antibiotic infusions, nursing teams can spend valuable time on caring for patients instead. There are many older people who are in the COVID-19risk group, and they are particularly prone to infections, especially since they have a higher chance of having a weakened immune system. I hope my idea improves the care process by allowing more time for interpersonal care for at-risk patients during these challenging times.

Fighting COVID-19 or being infected asymptomatically does not mean that there will no longer be any problems for patients. People who have had the disease complain about a weakened state of the body, and there are reports (The New England Journal of Medicine)of those who have been infected – including asymptomatically having a higher risk of stroke.

My idea is to assign a health visitor to patients who have hadCOVID-19. A nurse would regularly perform a telehealth interview, and then perhaps once a month make a physical visit to the patient’s home to conduct a clinical exam, an interview, and take blood for laboratory tests. The patient would have access to the nurse via telephone to raise any concerns of changing symptoms. The nurse would in turn coordinate efforts with health authorities.

My hope is that this type of monitoring of would help present and control complications after battling COVID-19. Monitoring and assessing patients after their illness would improve our overall treatment response in the future.

FinnHELP offers free, short-term discussion assistance for Finland’s healthcare professionals who are experiencing exhaustion or stress during our ongoing fight againstCOVID-19.During this time, we’ve been hosting video chat meetings for mentally and physically exhausted colleagues. We want to support their mental resilience and let them share their experience. We will publish more detailed results from FinnHELP discussions in the near future.

In April 2020, FinnHELP built a website, recruited professional support (crisis care professionals with expertise in acute care challenges), and built an appointment system for Finland's healthcare professionals.

Our fellow healthcare colleagues found us through an extensive national membership and social media follows.

Personal life stories are critical to the successful care of people living with dementia. Finding relaxing activities that are tailor-made to touch upon the person’s life history provides a great deal of meaning and wellbeing for his/her care. Unfortunately, during these COVID-19times, options to explore and go out are scarce.

My idea is to provide patients with an opportunity to revisit familiar places from their past through interactive video walks. The recorded walk would include both audio and video, and most importantly be filmed in a place of familiarity from the patient’s life – perhaps a neighborhood where he grew up; or perhaps walks in the forest with a dog if she did this as a child.

The ambition is to provide meaning, revive memories, and reduce anxiety and fear for dementia-diagnosed patients during tough COVID-19 conditions. I want to make this time more meaningful and interesting for our patients, and for them to revisit a life and time in the past that was a little more joyful and light.

During the pandemic, oral communication between patients and nurses has declined due to the high risk of infections. Patients often press the call button as they lack attention, communication, or support; and this has become even more apparent due to the restrictions on outside visitors.

For nurses, this presents a particularly stressful situation in which they are providing support and oftentimes non-health related information continuously along with the procedural and documentation work that must coincide with the call.

My idea is to facilitate patient to nurse communication and other healthcare professionals while avoiding potential infection risk with face-to-face contact.

As voice messaging is a very relevant part of our modern life and eases communications greatly, I would like to propose a similar idea in healthcare facilities as well. It may not always be necessary for a nurse to visit the patient. Perhaps a patient would like to ask for some help or information which might not be particularly urgent.

With “Voice Letters”, a patient can send a voice mail to the nurses station, where the team can receive and document the request. The nurses would be able to assess the urgency of the message, and prepare a response accordingly. I believe that this form of communication would be more useful than the usual call button, as oftentimes it is unclear whether the request is urgent or not.