Delirium risk screening and assessment among older patients in general wards and the emergency department: a best practice implementation project.


Journal

JBI evidence implementation
ISSN: 2691-3321
Titre abrégé: JBI Evid Implement
Pays: United States
ID NLM: 101772772

Informations de publication

Date de publication:
01 Dec 2023
Historique:
medline: 4 12 2023
pubmed: 20 11 2023
entrez: 20 11 2023
Statut: epublish

Résumé

The aim of this project was to improve compliance with evidence-based criteria regarding risk of delirium and the assessment of delirium among older patients in the general hospitalization wards and the emergency department. More than 50% of older hospitalized patients experience delirium. Some studies have highlighted the need to implement an orientation protocol in the emergency department and to continue this in the general wards, with the aim of decreasing the delirium rate among older patients admitted to hospital. The project followed the JBI evidence implementation framework. We conducted a baseline audit, a half-way audit, and final audit of 50 patients at risk of delirium admitted to the emergency department and the general wards, respectively. The audits measured compliance with eight criteria informed by the available evidence. In the final audit, three of the eight criteria achieved more than 50% compliance in the general wards: pressure injury screening (96%); monitoring changes (74%); and performing interventions (76%). In the emergency department, worse results were reported because of the service conditions. The exception was the criterion on the training of nurses on the topic, with 98%. The integration of a tool to screen for delirium in older patients in the hospital's electronic clinical history records increased the percentage of compliance with audit criteria regarding the use of the scale and delirium detection (rising from 0% to 32% in the final audit in the general wards). Through the implementation of this project, validated and evidence-based evaluation will ensure that nurses are supported through appropriate measures to reduce patient confusion and aggression resulting from delirium.

Identifiants

pubmed: 37982204
doi: 10.1097/XEB.0000000000000393
pii: 02205615-990000000-00069
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

S9-S18

Informations de copyright

Copyright © 2023 JBI. Unauthorized reproduction of this article is prohibited.

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Auteurs

Laura Lafarga-Molina (L)

Hospital Univesitario Miguel Servet, Zaragoza, Spain.
Spanish Centre for Evidence-Based Nursing and Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain.

Laura Albornos-Muñoz (L)

Spanish Centre for Evidence-Based Nursing and Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain.
Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain.
Research Network on Chronicity, Primary Care and Health Prevention and Promotion (RICAPPS), Madrid, Spain.

Esther González-María (E)

Spanish Centre for Evidence-Based Nursing and Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain.
Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain.
Biomedical Research Network Centre (CIBER) on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.

Tereza Vrbová (T)

Cochrane Czech Republic, Czech Republic: A JBI Centre of Excellence, Czech GRADE Network, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

María Teresa Moreno-Casbas (MT)

Spanish Centre for Evidence-Based Nursing and Healthcare: A JBI Centre of Excellence, Instituto de Salud Carlos III, Madrid, Spain.
Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain.
Biomedical Research Network Centre (CIBER) on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.

Miloslav Klugar (M)

Cochrane Czech Republic, Czech Republic: A JBI Centre of Excellence, Czech GRADE Network, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Jitka Klugarová (J)

Cochrane Czech Republic, Czech Republic: A JBI Centre of Excellence, Czech GRADE Network, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

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