Evaluating the effectiveness of educational interventions to prevent delirium

Wand, Anne

doi:10.1111/j.1741-6612.2010.00502.x

Cited by 21 publications

(20 citation statements)

References 49 publications

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“…Most Type 1 studies did not report clinical performance and patient care outcomes but reported improved knowledge and self‐confidence in recognizing delirium, except two that reported improved recognition of delirium and behavior modification . Expectations for measurable effect on clinical outcomes in these studies is low, with the literature showing that isolated educational interventions involving predisposing factors alone are not effective in improving healthcare outcomes or changing provider behavior …”

Section: Discussionmentioning

confidence: 94%

“…An adaptation of the PRECEDE model was used to study the effectiveness of continuing medical education for physicians, but it is not known whether the same classification can be applied to most of the studies in this review that focus on interventions for nurses and allied health professionals. This point is significant because most of the interventions focused on nonphysician professionals, but use of the PRECEDE model has strong precedent in this type of review and provides an effective framework for characterizing educational interventions …”

Section: Discussionmentioning

confidence: 99%

“…9 Expectations for measurable effect on clinical outcomes in these studies is low, with the literature showing that isolated educational interventions involving predisposing factors alone are not effective in improving healthcare outcomes or changing provider behavior. [36][37][38] Type 2 studies typically involved education sessions with assessment tools and protocols for practice. Most did not report patient care outcomes and change in practice behavior, but many showed significant gain in knowledge or self-confidence, one showed change in behavior, 24 and two showed improved recognition of delirium.…”

Section: Discussionmentioning

confidence: 99%

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Educational Interventions to Improve Recognition of Delirium: A Systematic Review

Yanamadala

Wieland

Heflin

2013

J American Geriatrics Society

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Delirium is a common and serious condition that is underrecognized in older adults in a variety of healthcare settings. It is poorly recognized because of deficiencies in provider knowledge and its atypical presentation. Early recognition of delirium is warranted to better manage the disease and prevent the adverse outcomes associated with it. The purpose of this article is to review the literature concerning educational interventions focusing on recognition of delirium. The Medline and Cumulative Index to Nursing and Allied Health Literature (CINHAL) databases were searched for studies with specific educational focus in the recognition of delirium, and 26 studies with various designs were identified. The types of interventions used were classified according to the Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model, and outcomes were sorted according to Kirkpatrick's hierarchy. Educational strategies combining predisposing, enabling, and reinforcing factors achieved better results than strategies that included one or two of these components. Studies using predisposing, enabling, and reinforcing strategies together were more often effective in producing changes in staff behavior and participant outcomes. Based on this review, improvements in knowledge and skill alone seem insufficient to favorably influence recognition of delirium. Educational interventions to recognize delirium are most effective when formal teaching is interactive and is combined with strategies including engaging leadership and using clinical pathways and assessment tools. The goal of the current study was to systematically review the published literature to determine the effect of educational interventions on recognition of delirium.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Educational Interventions to Improve Recognition of Delirium: A Systematic Review

Yanamadala

Wieland

Heflin

2013

J American Geriatrics Society

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“…18 Change in healthcare practice is challenging and requires complex, multi-modal educational strategies combining predisposing, enabling and reinforcing factors. 19,20 Predisposing factors include disseminating information, communication and didactic teaching. Enabling factors facilitate the desired change in performance by using protocols, guidelines and providing resources.…”

Section: Discussionmentioning

confidence: 99%

An Australian hospital's training program and referral pathway within a multi‐disciplinary health–justice partnership addressing family violence

Forsdike

Humphreys

Diemer

et al. 2018

Australian and New Zealand Journal of Public Health

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Objective: An innovative health-justice partnership was established to deliver legal assistance to women experiencing family violence who attended an Australian hospital. This paper reports on a multifaceted response to build capacity and willingness of health professionals to identify signs of family violence and engage with referral pathways to on-site legal assistance. Methods:A Realistic Evaluation analysed health professionals' knowledge and attitudes towards identification, response and referral for family violence before and after training; and use of referral pathways. Results:Of 123 health professionals participating in training, 67 completed baseline and follow-up surveys. Training improved health professionals' self-reported knowledge of, and confidence in, responding to family violence and understanding of lawyers' roles in hospitals. Belief that patients should be referred to on-site legal services increased. Training did not correspond to actual increased referrals to legal assistance. Conclusion:The program built capacity and willingness of health professionals to identify signs of, and respond to, family violence. Increase in referral rates to legal assistance was not shown. Potential improvements include better data capture and greater availability of legal services.Implications for public health: Strong hospital system supports and reliable recording of family violence referrals need to be in place before introducing such partnerships to other hospitals.

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“…Of the studies that have been reported, results generally indicate that, while education can improve knowledge of dementia [13, 16], and delirium [17], education in isolation has little effect on clinical practice [18]. By comparison, the use of knowledge translation principles has been shown to be more effective in producing practice change and preventing delirium [10, 18, 19], and are recommended [20, 21]. …”

Section: Introductionmentioning

confidence: 99%

CogChamps – a model of implementing evidence-based care in hospitals: study protocol

Travers

Graham

Henderson

et al. 2017

BMC Health Serv Res

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BackgroundDelirium and dementia (cognitive impairment; CI), are common in older hospital patients, and both are associated with serious adverse outcomes. Despite delirium often being preventable, it is frequently not recognized in hospital settings, which may be because hospital nurses have not received adequate education or training in recognizing or caring for those with CI. However, the most effective way of increasing nurses’ awareness about delirium and dementia, and initiating regular patient screening and monitoring to guide best practices for these patients in hospital settings is not known. Hence this current project, conducted in 2015–2017, aims to redress this situation by implementing a multi-component non-pharmacological evidence-based intervention for patients with CI, through educating and mentoring hospital nurses to change their practice.MethodsThe development of the practice change component is informed by recent findings from implementation science that focuses on facilitation as the active ingredient in knowledge uptake and utilization. This component focuses on educating and empowering experienced nurses to become Cognition Champions (CogChamps) across six wards in a large Australian tertiary referral hospital. The CogChamps will, in turn, educate other nursing team members to more effectively care for patients with CI. The hospital leadership team are supportive of the project and are directly involved in selecting the CogChamps. CogChamps will be provided with comprehensive education in evidence-based delirium assessment, prevention and management, and practice change management skills. They will receive continuing support from research and education staff about raising awareness, upskilling other staff in delirium assessment and in the adoption of best practices for preventing and managing delirium. Both qualitative and quantitative data are being collected at multiple time-points to evaluate process, impact and outcome, and to provide clarity regarding the most effective aspects of the intervention.DiscussionThis paper describes the study protocol for the implementation of multi-component evidence-based non-pharmacological practices designed to improve the care of older hospital patients with CI. Findings will inform subsequent initiatives directed towards enhancing the capacity of the nursing workforce to implement best practices for providing high quality care for this growing patient population throughout their acute care hospital stay.

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Evaluating the effectiveness of educational interventions to prevent delirium

Cited by 21 publications

References 49 publications

Educational Interventions to Improve Recognition of Delirium: A Systematic Review

Educational Interventions to Improve Recognition of Delirium: A Systematic Review

An Australian hospital's training program and referral pathway within a multi‐disciplinary health–justice partnership addressing family violence

CogChamps – a model of implementing evidence-based care in hospitals: study protocol

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