Effectiveness of Interprofessional Consultation-Based Interventions for Delirium: A Scoping Review

Abstract

Background: Interprofessional geriatric consultation teams and multicomponent interventions are established models for delirium care. They are combined in interprofessional consultative delirium team interventions; however, insight into this novel approach is lacking. Objective: To describe the effectiveness and core components of consultation-based interventions for delirium. Method: Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, and ProQuest. Data on core intervention components, outcomes, facilitators, and barriers were extracted. Results: 10 studies were included. Core intervention components were systematic delirium screening, ongoing consultation, implementation of non-pharmacologic and pharmacological interventions, and staff education. Of the included studies, 1/6 found a significant reduction in delirium incidence, 1/2 a reduction in delirium duration, and 2/3 found a reduction in falls. Facilitators and barriers to implementation were discussed. Conclusion: There was consistency in team structure and core components, however intervention operationalization and effectiveness varied widely. There is some evidence that this model is effective for reducing delirium and its sequelae.

Demonstrating the Value of a Standardized Cognitive Assessment Tool Through the Use of Interprofessional Rapid Safety Rounds

“…Leadership involved in the unit's Rapid Safety Rounds (RSR), including occupational therapists (OT), psychiatric nurses, and direct care nurses, postulated that patients were at increased risk of falls and other injuries due to lack of assessment of functional cognitive status and lack of communication regarding cognitive changes. 15 As such, a comprehensive cognitive assessment tool was developed. The purpose of this article is to describe the development of a cognitive assessment tool, the Cognitive Pyramid, which was used as a framework for the health care team to screen, track, and monitor patients along the cognitive continuum and proactively advance the plan of care while also decreasing falls.…”

“…Additionally, during interprofessional safety rounds on the unit, leadership identified that nurses often did not fully assess nor correctly use tools for cognitive and mental status variation, which caused them to misinterpret or ignore patient behavior that may have put them at higher risk for falls. Leadership involved in the unit's Rapid Safety Rounds (RSR), including occupational therapists (OT), psychiatric nurses, and direct care nurses, postulated that patients were at increased risk of falls and other injuries due to lack of assessment of functional cognitive status and lack of communication regarding cognitive changes 15…”