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Observational Study
. 2019 Sep:38 Suppl 2:98-106.
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

Susan Kurrle  1 , Cath Bateman  1 , Anne Cumming  1 , Glen Pang  2 , Sigrid Patterson  2 , Anthea Temple  2
Affiliations
Observational Study

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

Susan Kurrle et al. Australas J Ageing. 2019 Sep.

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.

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References

REFERENCES

    1. Australian Commission on Safety and Quality in Health Care. A Better Way to Care: Safe and High Quality Care for Patients with Cognitive Impairment (Delirium and Dementia) in Hospital - Actions for Health Service Managers. Sydney, NSW: ACSQHC; 2014.
    1. Inouye S, Westendorp R, Saczynski J. Delirium in elderly people. Lancet. 2014;383:911-922.
    1. Fogg C, Peter Griffiths P, Meredith P, Bridges J. Hospital outcomes of older people with cognitive impairment: an integrative review. Int J Geriatr Psychiatry. 2018;33:1177-1197.
    1. Australian Institute of Health and Welfare. Dementia Care in Hospitals: Costs and Strategies. Cat. No. AGE 72. Canberra, ACT: AIHW; 2013.
    1. Caplan GA, Kurrle SE, Cumming A. Appropriate care for older people with cognitive impairment in hospital. Med J Aust. 2016;205(10):S12-S15.

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