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Title: Effects of the interdisciplinary Basel delirium and dementia prevention and management program DEMDEL
Author: Hasemann, Wolfgang
Awarding Body: Glasgow Caledonian University
Current Institution: Glasgow Caledonian University
Date of Award: 2013
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Background: In hospital, delirium is a relatively common complication of acute illness and medical procedures among high risk patients groups such as older patients and patients with dementia. The experience of delirium is frightening and likened to a nightmare, in addition to the acute and distressing state the long-term consequences are detrimental. It is estimated that one third of deliria are preventable, to minimise negative consequences the remaining two thirds have to be managed. However, delirium management is variable and often overlooked. The evidence of the benefits of early intervention and treatment for patients with dementia is unclear although generally presumed to be beneficial. The aim of this study was to investigate the effect a systematic dementia-delirium management program DEMDEL on patient outcomes and to explore implementation challenges and patient acceptability. Methods: Central to this investigation was a mixed method intervention study. The main study focussed on quantitative outcome measures. An additional small qualitative investigation of practice delivery issues and user experiences was achieved through in-depth interviews with patients and focus group interviews with nurses. Setting: The study was conducted on four wards of the Medical Department of the University Hospital Basel in Switzerland. Sample: 268 patients aged 70 years and above with cognitive impairment participated in the before-after comparison study, 8 patients in the qualitative interviews and IQ nurses in two focus groups. Measurements: Daily delirium was measured using the Confusion Assessment Method (Cam) and the Delirium Rating Scale Revised 98 (DRS-R-98). Interventions: Nurses and physicians received training sessions on the state of the art concerning the prevention, early recognition and treatment of deliria. An algorithm (DemDel) on prevention of delirium, systematic screening for cognitive impairment and delirium by nurses and 00 the handling of delirious patients was introduced: Nurses identified high risk patients; i.e. patient with cognitive impairment using the clock drawing test, influenced the doctor's prescription of sleeping and delirium rescue medications, conducted systematic delirium screening with the Delirium Observation Scale and immediately administered the prescribed rescue medication after the onset of delirium.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available