Multidisciplinary team interventions for delirium in patients with chronic cognitive impairment

Britton, Annette; Russell, R. G. G.

doi:10.1002/14651858.cd000395.pub2

Cited by 25 publications

(17 citation statements)

References 22 publications

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“…Furthermore in the literature there is an ongoing debate on the benefit and cost effectiveness of trained intervention groups who strive for early diagnosis and treatment of the postoperative delirium. [19][20][21][22] The aim of this study was to retrospectively review charts of patients more than 70 years of age with a secondary peritonitis of colorectal origin who underwent emergency surgery and describe the frequency of the development of a postoperative delirium and the associated morbidity and mortality. Furthermore we tried to assess perioperative physiologic parameters and scores that may correlate with postoperative delirium and its consequences.…”

mentioning

confidence: 99%

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Engelberger

Zürcher

Schuld

et al. 2012

International Surgery

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Postoperative delirium, morbidity, and mortality in our elderly patients with secondary perionitis of colorectal origin is described. This is a chart-based retrospective analysis of 63 patients who were operated on at the University Hospital Basel from April 2001 to May 2004. Postoperative delirium occurred in 33%. Overall morbidity was 71.4%. Surgery-related morbidity was 43.4%. Mortality was 14.4%. There was no statistical significance between delirium, morbidity and mortality (P = 0.279 and P = 0.364). There was no statistically significant correlation between the analyzed scores (American Society of Anesthesiologists classification, Mannheimer Peritonitis Index, Acute Physiology and Chronic Health Evaluation score II, physiological and operative surgical severity and enumeration of morbidity and mortality score' or short 'cr-POSSUM') and postoperative delirium, morbidity or mortality. Postoperative delirium occurred in one-third of the patients, who seem to have a trend to higher morbidity. Even if the different scores already had proven to be predictive in terms of morbidity and mortality, they do not help the risk stratification of postoperative delirium, morbidity, or mortality in our collective population.

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mentioning

confidence: 99%

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Engelberger

Zürcher

Schuld

et al. 2012

International Surgery

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“…We developed a draft intervention based on the research evidence for effective interventions for delirium [20][21][22][23][32][33][34], and for changing practice [4,5,27,[35][36][37][38].…”

Section: Design Of the Interventionmentioning

confidence: 99%

“…As the strongest evidence is for delirium prevention through addressing common risk factors [32][33][34], this was chosen as the focus of the intervention. Figure 1 lists the broad principles of our intervention.…”

Section: Design Of the Interventionmentioning

confidence: 99%

Educating staff working in long-term care about delirium: The Trojan horse for improving quality of care?

Siddiqi

Young

Cheater

et al. 2008

Journal of Psychosomatic Research

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Objective: To design a multi-component intervention to improve delirium care in long-term care facilities for older people in the UK, and to identify the levers and barriers to its implementation in practice. Methods:The research incorporated the theoretical phase and phase 1 of the MRC framework. We designed a multi-component intervention based on the evidence for effective interventions for delirium and for changing practice. We refined the intervention with input from care home staff and field visits to homes.Our intervention incorporated the following features: targeting risk factors for delirium; a 'delirium practitioner' functioning as a facilitator; an education package for care home staff; staff working groups at each home to identify barriers to improving delirium care, and to produce tailored solutions; a local champion identified from the working groups; consultation; liaison with other professionals; audit or feedback.The delirium practitioner recorded her experiences of delivering the intervention in a contemporaneous log. This was analysed using framework analysis to determine the levers and barriers to implementation. Results:We introduced a multi-component intervention for delirium in 6 care homes in Leeds. Levers to implementation, included flexibility, tailoring training to staff needs, engendering pride and ownership amongst staff, and minimising extra work.Barriers included time constraints, poor organisation, and communication problems. Conclusion:We were able to design and deliver an evidence-based multi-component intervention for delirium that was acceptable to staff. The next steps are to establish its feasibility and effectiveness in modifying outcomes for residents of care homes.

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“…La prevalencia en pacientes hospitalizados fluctúa entre 10% y 30% 4 , y en el grupo más vulnerable, que son los pacientes mayores de 65 años (AM) hospitalizados, puede alcanzar hasta 60% 1,[5][6][7] .…”

Section: N V E S T I G a C I ó Nunclassified

“…Lo anterior, conduce a un importante aumento en los costos de atención de salud comparados con los AM que no lo presentan [1][2][3][4][5][6][7][8] .…”

Section: N V E S T I G a C I ó Nunclassified

Subdiagnóstico de delirium en adultos mayores hospitalizados

et al. 2005

Rev. méd. Chile

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Multidisciplinary team interventions for delirium in patients with chronic cognitive impairment

Cited by 25 publications

References 22 publications

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Educating staff working in long-term care about delirium: The Trojan horse for improving quality of care?

Subdiagnóstico de delirium en adultos mayores hospitalizados

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