Beyond Grand Rounds: A Comprehensive and Sequential Intervention to Improve Identification of Delirium

Autor/inn/en	Ramaswamy, Ravishankar; Dix, Edward F.; Drew, Janet E.; Diamond, James J.; Inouye, Sharon K.; Roehl, Barbara J. O.
Titel	Beyond Grand Rounds: A Comprehensive and Sequential Intervention to Improve Identification of Delirium
Quelle	In: Gerontologist, 51 (2011) 1, S.122-131 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0016-9013
DOI	10.1093/geront/gnq075
Schlagwörter	Older Adults; Hospitals; Patients; Mental Disorders; Clinical Diagnosis; Intervention; Knowledge Level; Neurological Impairments; Pretests Posttests; Scores + Suchen Sie Ihr Suchwort? Älterer Erwachsener; Krankengymnast; Krankenhaus; Patient; Mental illness; Geisteskrankheit; Wissensbasis; Neurodegenerative Erkrankung
Abstract	Purpose of the Study: Delirium is a widespread concern for hospitalized seniors, yet is often unrecognized. A comprehensive and sequential intervention (CSI) aiming to effect change in clinician behavior by improving knowledge about delirium was tested. Design and Methods: A 2-day CSI program that consisted of progressive 4-part didactic series, including evidence-based reviews of delirium recognition, prevention, and management, interspersed with interactive small group sessions and practical case conferences was conceptualized in consultation with a leading expert on delirium. Pretest and posttest instruments were designed to test the attendees on their knowledge and confidence around delirium identification. Results: An average of 71 people attended each didactic session. Among all responses, 50 pretests and posttests were matched based on numeric coding (6 MD/DOs, 34 RNs, and 10 others). Mean pretest and posttest scores were 7.9 and 10.8 points, respectively (maximum: 17), showing a positive change in knowledge scores after the intervention (2.9 points, p less than 0.001). Improvement in knowledge scores was higher in the cohort attending 2 or more lectures (3.8 points, p less than 0.001) compared with those attending only 1 lecture (1.3 points, p less than 0.12). Confidence in identifying patients with delirium increased by 28% (p less than 0.001), and self-assessed capacity to correctly administer the Confusion Assessment Method increased by 36% (p less than 0.001). Implications: A novel CSI increased clinician knowledge about delirium identification and management and improved confidence and self-assessed capacity to identify delirium in the hospitalized elderly patients. This strategy, which incorporates multiple reinforcing modes of education, may ultimately be more effective in influencing clinician behavior when compared with traditional grand rounds. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10