Kurrle Susan, Bateman Cath, Cumming Anne, Pang Glen, Patterson Sigrid, Temple Anthea
Cognitive Decline Partnership Centre, University of Sydney, Sydney, New South Wales, Australia.
Agency for Clinical Innovation, NSW Ministry of Health, Sydney, New South Wales, Australia.
Australas J Ageing. 2019 Sep;38 Suppl 2:98-106. doi: 10.1111/ajag.12690.
To evaluate the implementation of a model of care known as the Confused Hospitalised Older Persons (CHOPs) program to improve recognition, assessment and management of older persons with cognitive impairment (delirium and/or dementia) admitted to acute hospitals.
The model of care was implemented in six selected hospitals across New South Wales. Pre- and postimplementation medical record audits, environmental audits, and staff knowledge and care confidence surveys were performed. Interviews with clinical leads postimplementation identified enablers and barriers.
There were significant increases in cognitive screening within 24 hours (OR = 3.32 [2.50-4.91]), delirium risk identification (OR = 4.04 [2.89-5.64]), assessment of cognitive impairment (OR = 2.55 [1.90-3.43]) and interaction with families (OR = 2.81 [2.09-3.79]). Staff education and care confidence were improved, and positive environmental changes occurred in all hospitals. Barriers and enablers to implementation were identified.
The CHOPs program improved identification, risk assessment and management of cognitive impairment in older hospitalised patients.
评估一种名为“住院老年认知障碍患者（CHOPs）计划”的护理模式的实施情况，以改善对入住急性医院的认知障碍（谵妄和/或痴呆）老年患者的识别、评估和管理。
在新南威尔士州的六家选定医院实施该护理模式。实施前后进行了病历审核、环境审核以及员工知识和护理信心调查。实施后对临床负责人进行访谈，确定了促进因素和障碍。
24小时内认知筛查（比值比[OR]=3.32[2.50-4.91]）、谵妄风险识别（OR=4.04[2.89-5.64]）、认知障碍评估（OR=2.55[1.90-3.43]）以及与家属互动（OR=2.81[2.09-3.79]）均显著增加。员工教育和护理信心得到改善，所有医院的环境都有积极变化。确定了实施的障碍和促进因素。
CHOPs计划改善了老年住院患者认知障碍的识别、风险评估和管理。
