None listed
Conditions
Brief summary
Delirium is a common medical problem characterized by changes in medical function. It occurs in older patients with severe illness. Studies suggest that hospital staff do not always identify that a patients has delirium and so identification and treatment of causes as well as appropriate nursing management may be delayed. This project has been funded by Queensland Health. In this project, all patients aged over 65 years will be assessed for the presence of delirium and their risk of developing delirium. Patients wiith established delirium or an intermediate -high risk assessment will be admitted directly from the Emergency Department to the intervention ward. The intervention ward will be modified to provide an appropriate sensory environment. Patients will then undergo comprehensive medical, nursing and allied health assessment with regard to modifiable risk factors. Treatment will be conducted according to Clinical Practice Guidelines for the Management of Delirium in Older People. Nursing assistants, volunteers and carers will form a valuable part of the intervention. Outcomes of care with this method will be compared to the usual medical, nursing and multidisciplinary care currently provided on the other medical wards.
Interventions
Patients with established delirium or an intermediate-high risk assessment will be identified through early screening and fast tracked from the Emergency Department to the intervention ward. The intervention ward will be modified to provide an appropriate sensory environment. The intervention will be administered by the existing multidisciplinary team and will be in line with Clinical Practice Guidelines for the prevention and treatment of delirium. Patients will undergo comprehensive medical,
Patients with established delirium or an intermediate-high risk assessment will be identified through early screening and fast tracked from the Emergency Department to the intervention ward. The intervention ward will be modified to provide an appropriate sensory environment. The intervention will be administered by the existing multidisciplinary team and will be in line with Clinical Practice Guidelines for the prevention and treatment of delirium. Patients will undergo comprehensive medical, nursing and allied health assessment with regard to modifiable risk factors. Nursing assistants, volunteers and carers will assist in re-orientation and distraction therapy. The intervention will continue for the duration of the patient's admission.
Sponsors
Dr Catherine Maussen
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients are eligible for study if admitted to participating medical units; aged 65 years or greater; and at intermediate-high risk of delirium following application of screening tool.
Exclusion criteria
Palliative patients; combative/dangerous behaviour; hyperactive delirium requiring AIN special >4 hours daily; non invasive ventilation/tracheostomy; post ICU; severe psychiatric disorder preventing participation in interventions; severe dementia; discharge anticipated within 72 hours admission; aphasia; any condition not listed above that prevents participation in intervention ward programme
Outcome results
None listed