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停止谵妄!预防养老院谵妄的综合干预措施:一项混合方法可行性研究。

Stop Delirium! A complex intervention to prevent delirium in care homes: a mixed-methods feasibility study.

机构信息

Bradford District NHS Care Trust, New Mill, Saltaire, West Yorkshire BD18 3LD, UK.

出版信息

Age Ageing. 2011 Jan;40(1):90-8. doi: 10.1093/ageing/afq126. Epub 2010 Sep 22.

Abstract

BACKGROUND

delirium is likely to be particularly common in care homes, given the clustering of known risk factors in these settings. Preventing delirium should result in significant benefits, including better quality of care and improved outcomes for residents.

OBJECTIVE

to test the feasibility of 'Stop Delirium!', an intervention to prevent delirium in care homes for older people, and to optimise parameters to inform the design of a future trial evaluation.

METHOD

we delivered Stop Delirium! to six care homes over 10 months, in a mixed methods before and after study.

RESULTS

Stop Delirium! was successfully implemented in the study homes. We found evidence supporting positive changes in staff attitudes and practice after the intervention. Although qualitative data suggested it was too early to expect changes in resident outcomes, we also found preliminary evidence suggesting potential improvements in a range of outcomes, including a reduction in the number of falls and prescribed medications.

CONCLUSION

a complex intervention for delirium prevention in care homes is feasible and has the potential to improve staff practice and outcomes for residents. This work provides the basis for the next phase of the evaluation to establish its effectiveness and cost-effectiveness.

摘要

背景

鉴于谵妄的已知风险因素在这些环境中聚集,因此在养老院中,谵妄可能特别常见。预防谵妄应该会带来显著的益处,包括改善居民的护理质量和结果。

目的

测试“阻止谵妄!”预防老年人护理院谵妄的干预措施的可行性,并优化参数,为未来的试验评估提供设计信息。

方法

我们在混合方法的前后研究中,将“阻止谵妄!”在六个月内应用于六家养老院。

结果

“阻止谵妄!”在研究中的养老院中成功实施。我们发现干预后有证据支持员工态度和实践的积极变化。尽管定性数据表明预计居民结果的变化还为时过早,但我们也发现了初步证据表明,在一系列结果方面可能存在改善,包括跌倒次数和规定药物的减少。

结论

养老院中预防谵妄的复杂干预措施是可行的,并且有可能改善员工的实践和居民的结果。这项工作为下一阶段的评估提供了基础,以确定其有效性和成本效益。

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