Event Title
Reducing Delirium and Functional Decline in Hospitalized Older Adults: Pre-Implementation Of CoCare Help
Location
Hager-Lubbers Exhibition Hall
Description
PURPOSE: Delirium is a change in consciousness characterized by rapid onset and fluctuating attention, causing impairment in the ability to process and recall information, occurring in 30% of hospitalized older adults. Delirium can increase falls, length-of-stay, mortality, and cost. CoCare HELP (Hospital Elder Life Program) is an evidence-based bundle of interventions targeting cognitive impairment, sleep deprivation, immobility, visual/hearing impairment, and dehydration, embedding geriatric principles in care to prevent delirium. SUBJECTS: Hospitalized adults aged 70 years or older in the Midwest. METHODS: Mixed methods were used to collect retrospective/prospective data (interviews (N=25], surveys [N=25], chart audits [N=500]) for an organization assessment from CoCare experts, the hospital, clinicians, and patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided a systematic review on implementation strategies. ANALYSES: Descriptive statistics (SPSS) and thematic analysis were used. RESULTS: A high rate of falls (0.27/1000-days), length-of-stay (6.1 days), readmission rate (12.6%), restraint use (19,197 hours), drugs prescribed (15.4%) and delirium (30.2%) were found. The review identified 10 strategies to guide implementation of HELP: engaging stakeholders/champions, educating staff/patients, clinical team creation/use, facilitation, auditing and feedback, examining satisfaction, and public relations. Products completed included: An undergraduate course, registered nurse education, an implementation toolkit, clinician competency checklists, system budgeting plan, system sustainability plan, project analysis plan, recruitment fliers and electronic health record documentation. CONCLUSIONS: Use of HELP can prevent delirium. The identification of a high rate of delirium was confirmed in the hospital. The products developed will enable the hospital to implement HELP over the next year.
Reducing Delirium and Functional Decline in Hospitalized Older Adults: Pre-Implementation Of CoCare Help
Hager-Lubbers Exhibition Hall
PURPOSE: Delirium is a change in consciousness characterized by rapid onset and fluctuating attention, causing impairment in the ability to process and recall information, occurring in 30% of hospitalized older adults. Delirium can increase falls, length-of-stay, mortality, and cost. CoCare HELP (Hospital Elder Life Program) is an evidence-based bundle of interventions targeting cognitive impairment, sleep deprivation, immobility, visual/hearing impairment, and dehydration, embedding geriatric principles in care to prevent delirium. SUBJECTS: Hospitalized adults aged 70 years or older in the Midwest. METHODS: Mixed methods were used to collect retrospective/prospective data (interviews (N=25], surveys [N=25], chart audits [N=500]) for an organization assessment from CoCare experts, the hospital, clinicians, and patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided a systematic review on implementation strategies. ANALYSES: Descriptive statistics (SPSS) and thematic analysis were used. RESULTS: A high rate of falls (0.27/1000-days), length-of-stay (6.1 days), readmission rate (12.6%), restraint use (19,197 hours), drugs prescribed (15.4%) and delirium (30.2%) were found. The review identified 10 strategies to guide implementation of HELP: engaging stakeholders/champions, educating staff/patients, clinical team creation/use, facilitation, auditing and feedback, examining satisfaction, and public relations. Products completed included: An undergraduate course, registered nurse education, an implementation toolkit, clinician competency checklists, system budgeting plan, system sustainability plan, project analysis plan, recruitment fliers and electronic health record documentation. CONCLUSIONS: Use of HELP can prevent delirium. The identification of a high rate of delirium was confirmed in the hospital. The products developed will enable the hospital to implement HELP over the next year.