Extrait

Background and study aims Delirium, or acute confusional illness, is common in older people. As many as a third of older people who have been admitted into hospital can develop delirium and many people do not fully recover. However, although evidence has shown that there is much that could be done to prevent delirium, the United Kingdom National Health Service does not have routine care systems capable of minimising the impact of this condition. We are undertaking a series of interlinked studies to investigate delirium prevention for older people in hospital. In the first study we worked closely with staff, volunteers and patient and carer representatives from three NHS Trusts to develop a delirium prevention system of care for use in National Health Service hospital wards. We have called this the Prevention of Delirium Programme. The Prevention of Delirium Programme is based on the evidence for delirium prevention and learning from our research partners in the previous study. It involves ward staff and volunteers addressing known modifiable risk factors for delirium (including, for example, infection, pain, poor mobility and sleep disturbance). The basis for this intervention is not a novel treatment approach but attempts to provide a comprehensive system of care that reliably and routinely drives up the standard of general care for vulnerable older patients at risk of delirium on general medical and surgical wards. The aim of the present study, which is the second in our programme of research to investigate delirium prevention for older people in hospital, is to test the Prevention of Delirium Programme system of care in hospital wards to see how well it works and how acceptable it is to patients, carers, volunteers and staff. Who can participate? Managers, staff and volunteers in participating wards and hospitals. Patients who have been admitted to participating wards and their carers. What does the study involve? We will introduce the Prevention of Delirium Programme 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 Prevention of Delirium Programme to see what impact it has on staff workload. We will assess the impact of the Prevention of Delirium Programme on patients’ satisfaction with care using questions from the national in-patient questionnaire survey. We will interview patients, carers, staff and hospital volunteers to see how acceptable the Prevention of Delirium Programme has been. We will collect data to assess how well the Prevention of Delirium Programme has been used in practice. We will analyse all the data to see how feasible and acceptable the Prevention of Delirium Programme 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. What are the possible benefits and risks of participating? There will be heightened awareness and knowledge of delirium prevention among the staff in the participating wards. The participating wards will be implementing a delirium prevention system of care with potential benefits to patients admitted to those wards – a particularly vulnerable group of patients susceptible to delirium. The Prevention of Delirium Programme is a ward-based quality-improvement programme with minimal associated risk for patients. There are no risks involved to staff and hospital volunteers over and above those associated with their usual ward-based activities. Where is the study run from? The Academic Unit of Elderly Care and Rehabilitation, Institute of Health Sciences, University of Leeds, UK. When is the study starting and how long is it expected to run? The study started in June 2011 and is scheduled to run for 18 months until November 2012. Who is funding the study? Funding has been obtained from the National Institute for Health Research as a Programme Grant for Applied Research. Who is the main contact? Chief Investigator: Professor John Young ([email protected]) Programme Manager: Dr John Green ([email protected])

Critère d'inclusion

• Generic Health Relevance: Age and ageing

Liens

• ictrp
• isrctn