Delirium Mental and Behavioural Disorders
Conditions
Interventions
The DAMPen-Delirium II study has three work packages:
1. Cluster Randomised Controlled Trial (CRCT)
This work package will evaluate the effectiveness of CLECC-Pal Delirium vs. usual practice on reduc
mid-shift cluster discussions by the professionals delivering care
peer observations of practice
reflective discussions
and action learning sets (all designed to implement changes in delirium screening, assessment and management).
Twenty palliative care units (charitably-funded or NHS) will be randomised (1:1) to the
Sponsors
University of Hull
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Inpatients/Carers Inclusion Criteria: 1. Inpatients with capacity to consent 2. Carers of inpatients with capacity to consent
Exclusion criteria
Exclusion criteria: Interview: Inpatients/Carers Exclusion Criteria: 1. Patients who do not have capacity at the point of interview will be withdrawn 2. Carers of inpatients without capacity to consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary outcome measures (clinical): The proportion of inpatient days affected by delirium for inpatients who experience delirium during PCU admission, calculated as the number of days they experience delirium (as identified with the Inouye tool by HHTU researchers) divided by their total number of inpatient days, measured using data extracted from patient records at one timepoint | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcomes (process-related and clinical): 1. Guideline adherence: The number of inpatient records that contain the following evidence of adherence to delirium care guidelines (for the detection, assessment, management and prevention of delirium) at baseline and follow-up: 1.1. Use of 4AT screening tool 1.2. Presence/absence of delirium risk assessment 1.3. Use of Richmond Agitation-Sedation Scale-Pal 1.4. Clinician-documented diagnosis of delirium 1.5. Clinician assessment of cause/reversibility 1.6. Presence/absence of delirium care plan 1.7 Use of antipsychotics in relation to documented harmful/distressing behaviour towards self or others 2. Cost-effectiveness: The incremental cost-effectiveness ratio measures the cost per PCU inpatient day saved by preventing delirium, measured using data collection from the cRCT linked with Hospital Episode Statistics (HES) at the end of the study 3. Inpatient Demographics measured using data extracted from patient records at one timepoint: 3.1. Age 3.2. Sex 3.3. Diagnosis 3.4. Ethnicity 3.5. Postcode (converted to IMD score at data collection) 3.6. Primary Medical Condition 3.7. Date of Death (if applicable) 3.8. Length of stay | — |
Countries
England, United Kingdom, Wales
Contacts
Public ContactGrant Constable
Outcome results
None listed