Effects of a Dementia-friendly Program on Detection and Management of Patients With Cognitive Impairment and Delirium in Acute-care Hospital Units: a Non-equivalent Control Group Design
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 423
- 试验地点
- 2
- 主要终点
- Detection of patients with cognitive impairment
研究概览
简要总结
Frail older persons with cognitive impairment are at special risk of experiencing delirium during acute hospitalisation. The purpose of this study was to investigate whether a dementia-friendly hospital program contributes to improved detection and management of patients with cognitive impairment and delirium.
详细描述
Study design This study, has a non-equivalent control group design and a historical control Group. The Control group received usual care and the experimental group received usual care plus the dementia-friendly program.
One Group received care after implementing the dementia-friendly hospital program. The study is performed at two medical wards at a large acute-care hospital in Norway. A medical pulmonary ward and a cardiac ward participated.
Data Collection:
Demographic data included age, gender, place of residence (home, adapted housing, institution), and family/relative network, and were obtained upon admission to the study.
Medical data included cause of admission, active medical diagnoses, medications and medical treatment, and were obtained both at admission and from their electronic medical records after discharge.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 75 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients ≥75 years
- •acute admission to the cardiac or pulmonary wards.
- •Patient who has given informed written consent, or proxy consent from relatives for patients who lacked cognitive capacity.
排除标准
- •Readmitted patients enrolled in a previous hospital stay.
- •Patients who do not have sufficient verbal function or hearing to communicate
- •Patients in a coma or too ill to participate
- •Patients who are isolated
- •Patients who do not wish to participate or relatives who do not want the patient to participate, in the cases where the patient lacked cognitive capacity to consent.
结局指标
主要结局
Detection of patients with cognitive impairment
时间窗: During the stay at the participating wards, assessed from the electronical medical record within 6 months after discharge
Proportion of patients identified with cognitive impairment during the hospital stay, documented in the electronic Medical record. Difference between the control group and the intervention group. Patients were assessed with The Four Assessment Test at admission and during the stay at the participating wards. Furthermore, documentation of cognitive impairment in the electronic medical journal during the stay were assessed after discharge.
Management of patients with cognitive impairment and delirium
时间窗: During the stay at the participating wards, assessed from the electronical medical record within 6 months after discharge
Proportion of patients identified with cognitive impairment, delirium or at risk of delirium who has documented interventions to prevent and/or treat delirium, according to the implemented dementia-friendly program.Differences between the control group and the intervention group.
次要结局
- Delirium(Assessed from the electronical medical record, within 6 month after discharge)
- Use of medications not recommended for the patient group(During the stay at the participating wards, assessed from the electronical medical record within 6 months after discharge)
- Length of hospital stay(Assessed from the electronical medical record, within 6 month after discharge)
- 30-day mortality(Mortality were assessed from the electronical medical record 30 days after discharge.)
- Screening within 24 hours(Within 24 hours after admission to the ward)
- 30-day readmission to the hospital(Readmissions to the hospital were assessed from the electronical medical record 30 days after discharge.)
- Use of antipsychotics, hypnotics and sedatives(During the stay at the participating wards, assessed from the electronical medical record within 6 months after discharge)
- Departure to rehabilitation or nursing home(Assessed from the electronical medical record, within 6 month after discharge)
研究者
Nina Mickelson Weldingh
Prinsipal Investigator
University Hospital, Akershus