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Research Question
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Delirium, or acute confusional illness, is common in older people: as many as a third of hospitalised older people can develop delirium and many people do not fully recover. However, although there is much that could be done to prevent delirium, the NHS does not have routine care systems capable of minimising the impact of this condition.
In an ongoing study, we are developing a delirium prevention system of care for use in NHS hospital wards. We now want to test this delirium prevention system of care in hospital wards to see how well it works and how acceptable it is to patients, carers, volunteers and staff.
To do this, in cooperation with managers, staff and hospital volunteers, we will introduce the delirium prevention system of care on at least one ward in each of three hospitals over six months and implement it for a further six months. We will undertake an audit before and after implementation of the delirium prevention system of care to see what impact it had on staff workload. We will assess the impact of the delirium prevention system of care on patients’
satisfaction with care using questions from the national inpatient questionnaire survey. We will interview patients, carers, staff and hospital volunteers to see how acceptable the delirium prevention system of care has been. We will collect data to assess how well the delirium prevention system of care has been used in practice.
We will analyse all the data to see how feasible and acceptable the delirium prevention system of care has been and whether we need to alter it. If we find it has been successful, we plan to test the delirium prevention system of care in a future study to see if it reduces delirium. (from UKCRN Portfolio)
Additional lay summaries...
Lay summary under review 1 (from ISRCTN)
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Ethics Approval
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Bradford Research Ethics Committee, 25 October 2010, ref: 10/H1302/66
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Study Design
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Pilot observational qualitative trial
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Design Type
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Sorry, not currently available
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Design Details
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Sorry, not currently available
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Health Condition(s) or Problem
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Generic Health Relevance: Age and ageing
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Participants Inclusion Criteria
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Hospital staff and volunteers:
1. Introductory workshop and associated followup interviews
Workshop participants will include patient and carer representatives, hospital managers, clinical and voluntary service managers, volunteers, senior clinicians, nurses and therapists. We will arrange individual followup interviews with purposefully selected staff.
2. Delirium Prevention System of Care Implementation Teams
Team members will consist of staff having a potential interest/role in the delirium prevention system of care, e.g. senior manager, senior doctor, matron, nurse consultant and/or specialist nurse, staff nurse, therapist, manager of the volunteer service, volunteer, patient representative, care assistant and ward clerk or housekeeper.
3. Audit of the impact of the intervention on staff workload
All members of the participating ward team and volunteers involved in the delirium prevention intervention present on the participating wards during the audit which will occur over six shifts on each participating ward.
4. Acceptability to staff and volunteers
Interviews and focus groups with a sample of service managers, staff and volunteers from participating wards.
Patients and carers:
1. Patient satisfaction questionnaire
Consecutive patients about to be discharged from the participating wards at the start of the implementation phase and during the delivery phase of the intervention.
2. Patient description
All patients admitted to the participating wards over the six months of the delivery of the delirium prevention system of care intervention.
3. Audit of the impact of the intervention on staff workload
Patients present on the ward at the time of the audit which will occur over six shifts on each participating ward.
4. Acceptability to patients and carers
Interviews with a purposeful sample of patients discharged from participating wards and their carers with differing, positive and negative perceptions of care experiences identified through the satisfaction questionnaire
5. Male and femal participants
6. Aged 65 years and over
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Participants Exclusion Criteria
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1. Patients in a terminal phase of their illness
2. Does not meet inclusion criteria
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Participant Sex
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Sorry, not currently available
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Participant Age Range
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Sorry, not currently available
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Participant Type
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Sorry, not currently available
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Target Sample Size
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Planned Sample Size: 500; UK Sample Size: 500
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Date of First Enrolment
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Sorry, not currently available
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Date of Recruitment End
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Sorry, not currently available
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Date of End of Follow-up
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Sorry, not currently available
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Trial End Date
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Sorry, not currently available
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Recruitment Status
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Completed
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Overall Trial Status
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Sorry, not currently available
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Countries of Recruitment
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United Kingdom
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Nation
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England
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Location
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Bradford
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Interventions
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The intervention is a delirium prevention system of care ? the Prevention of Delirium (POD) Programme. The POD Programme is a ward-based, quality improvement programme which will be embedded in usual ward practice. The POD Programme will consist of a multicomponent intervention targeting ten modifiable delirium risk factors in older people in hospital: cognitive impairment / disorientation, dehydration and/or constipation, hypoxia, infection, limited mobility or immobility, pain, polypharmacy.
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Primary Outcome Measures
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We will undertake a before and after study in each of the case study sites.
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Secondary Outcome Measures
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No secondary outcome measures
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Website
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Sorry, not currently available
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