Implementation of a model of care for hospitalised older persons with cognitive impairment (the Confused Hospitalised Older Persons program) in six New South Wales hospitals
- PMID: 31496063
- DOI: 10.1111/ajag.12690
Implementation of a model of care for hospitalised older persons with cognitive impairment (the Confused Hospitalised Older Persons program) in six New South Wales hospitals
Abstract
Objective: 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.
Methods: 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.
Results: 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.
Conclusion: The CHOPs program improved identification, risk assessment and management of cognitive impairment in older hospitalised patients.
Keywords: cognitive dysfunction; delirium; dementia; hospitalization.
© 2019 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc.
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