ERIC Number: EJ910951
Record Type: Journal
Publication Date: 2011-Feb
Abstractor: As Provided
Beyond Grand Rounds: A Comprehensive and Sequential Intervention to Improve Identification of Delirium
Ramaswamy, Ravishankar; Dix, Edward F.; Drew, Janet E.; Diamond, James J.; Inouye, Sharon K.; Roehl, Barbara J. O.
Gerontologist, v51 n1 p122-131 Feb 2011
Purpose of the Study: Delirium is a widespread concern for hospitalized seniors, yet is often unrecognized. A comprehensive and sequential intervention (CSI) aiming to effect change in clinician behavior by improving knowledge about delirium was tested. Design and Methods: A 2-day CSI program that consisted of progressive 4-part didactic series, including evidence-based reviews of delirium recognition, prevention, and management, interspersed with interactive small group sessions and practical case conferences was conceptualized in consultation with a leading expert on delirium. Pretest and posttest instruments were designed to test the attendees on their knowledge and confidence around delirium identification. Results: An average of 71 people attended each didactic session. Among all responses, 50 pretests and posttests were matched based on numeric coding (6 MD/DOs, 34 RNs, and 10 others). Mean pretest and posttest scores were 7.9 and 10.8 points, respectively (maximum: 17), showing a positive change in knowledge scores after the intervention (2.9 points, p less than 0.001). Improvement in knowledge scores was higher in the cohort attending 2 or more lectures (3.8 points, p less than 0.001) compared with those attending only 1 lecture (1.3 points, p less than 0.12). Confidence in identifying patients with delirium increased by 28% (p less than 0.001), and self-assessed capacity to correctly administer the Confusion Assessment Method increased by 36% (p less than 0.001). Implications: A novel CSI increased clinician knowledge about delirium identification and management and improved confidence and self-assessed capacity to identify delirium in the hospitalized elderly patients. This strategy, which incorporates multiple reinforcing modes of education, may ultimately be more effective in influencing clinician behavior when compared with traditional grand rounds.
Descriptors: Older Adults, Hospitals, Patients, Mental Disorders, Clinical Diagnosis, Intervention, Knowledge Level, Neurological Impairments, Pretests Posttests, Scores
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Publication Type: Journal Articles; Reports - Evaluative
Education Level: Adult Education; Higher Education
Authoring Institution: N/A