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Using a multi-component intervention to improve delirium diagnosis and management on surgical wards (Record no. 76629)

MARC details
000 -LEADER
fixed length control field 02907cam a2200241 4500
001 - CONTROL NUMBER
control field NMDX7878
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 120401t2018 xxu||||| |||| 00| 0 eng d
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Bauernfreund, Y.
240 ## - UNIFORM TITLE
Uniform title <a href="Age and Ageing">Age and Ageing</a>
245 ## - TITLE STATEMENT
Title Using a multi-component intervention to improve delirium diagnosis and management on surgical wards
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT)
Date of publication, distribution, etc. 2018
500 ## - GENERAL NOTE
General note NMUH Staff Publications
500 ## - GENERAL NOTE
General note EMBASE
500 ## - GENERAL NOTE
General note 47
520 ## - SUMMARY, ETC.
Summary, etc. &lt;span style="font-size: 10pt;"&gt;Evidence-base: Delirium occurs frequently in both general surgical and orthopaedic patients. It is often neither detected nor managed appropriately. Delirium increases morbidity and mortality risk, as well as lengthening hospital stay. It is an unpleasant and frightening experience for patients. We used quality improvement tools and a multi-component intervention to improve the detection and management of delirium on the general surgical and orthopaedic wards. Change Strategies: We undertook a snapshot review of all general surgical and orthopaedic inpatients aged over 65 (n = 32). We assessed whether a delirium screening tool (4AT or CAM) had been completed on admission. If delirium was detected, we assessed whether investigation and management was adequate as per NICE &amp;amp; British Geriatric Society guidance, including adequate assessment of possible underlying causes and the use of orientation signage. After baseline data collection, we developed a multi-component intervention. This included targeted delirium education sessions for doctors and nursing staff involving training on use of the 4AT tool and the TIME ("Triggers, Investigations, Management, Engage") bundle, as well as introducing ward-based TIME checklists, an online delirium order set, and a bedside orientation tool. Change Effects: Second collection (n = 24) showed improvement in use of a delirium screening tool from 41% to 63%. Delirium prevalence increased from 31% to 38%. For patients with a diagnosed delirium, adequate assessment for causes and exacerbating factors for delirium increased from 30% to 56% of cases. Use of personal orientation tools improved from 0% to 56%. Conclusion: Following targeted education sessions and multiple ward-based interventions, the surgical wards have improved their screening and management of delirium. The improvements were greater on orthopaedic compared to general surgical wards. We believe further targeted staff education programmes and instituting nursing delirium "champions" for future PDSA cycles will maintain effective delirium management on the surgical wards.&amp;nbsp;&lt;/span&gt;
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Butler, M.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Singh, P.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Horowitz, M.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Ragavan, S.
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Sampson, Elizabeth L
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="https://academic.oup.com/ageing/article-abstract/47/suppl_2/ii25/4953891?">https://academic.oup.com/ageing/article-abstract/47/suppl_2/ii25/4953891?</a>
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="http://ferriman.wufoo.com/forms/journal-article-request/">http://ferriman.wufoo.com/forms/journal-article-request/</a>
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        Staff publications for NMDX Ferriman information and Library Service (North Middlesex) Ferriman information and Library Service (North Middlesex) Online 07/06/2022   07/06/2022 07/06/2022 UNKNOWN
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