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. 2024 Jul 25;24(1):633.
doi: 10.1186/s12877-024-05213-9.

Educational interventions aimed at improving knowledge of delirium among nursing home staff-a realist review

Vincent Molitor  1   2 , Theresa Sophie Busse  3 , Chantal Giehl  3   4 , Romy Lauer  3 , Ina Carola Otte  3 , Horst Christian Vollmar  3 , Petra Thürmann  5   6 , Bernhard Holle  7   8 , Rebecca Palm  7   9
Affiliations

Educational interventions aimed at improving knowledge of delirium among nursing home staff-a realist review

Vincent Molitor et al. BMC Geriatr. .

Abstract

Background: Delirium is a neuropathological syndrome that is characterised by fluctuating impairments in attention, cognitive performance, and consciousness. Since delirium represents a medical emergency, it can be associated with adverse clinical and economic outcomes. Although nursing home residents face a high risk of developing delirium, health care professionals in this field appear to have limited knowledge of delirium despite the critical role they play in the prevention, diagnosis, and treatment of delirium in nursing homes.

Objective: The purpose of this realist review is to develop an initial programme theory with the goal of understanding how, why, and under what circumstances educational interventions can improve the delirium-specific knowledge of health care professionals in nursing homes.

Methods: This realist review was conducted in accordance with the RAMESES (Realist And Meta-narrative Evidence Synthesis: and Evolving Standards) guidelines and includes the following steps: (1) search strategy and literature review; (2) study selection and assessment; (3) data extraction; (4) data synthesis; and (5) development of an initial programme theory. It also included stakeholder discussions with health care professionals recruited from nursing home care, which focused on their experiences with delirium.

Results: From a set of 1703 initially identified publications, ten publications were included in this realist review. Based on these publications, context-mechanism-outcome configurations were developed; these configurations pertained to (1) management support, (2) cognitive impairments among residents, (3) familiarity with residents, (4) participatory intervention development, (5) practical application, (6) case scenarios, (7) support from experts and (8) relevance of communication.

Conclusions: Educational interventions aimed at improving the delirium-specific knowledge of health care professionals should feature methodological diversity if they are to enhance health care professionals' interest in delirium and highlight the fundamental contributions they make to the prevention, diagnosis, and treatment of delirium. Educational interventions should also take into account the multidimensional contextual factors that can have massive impacts on the relevant mode of action as well as the responses of health care professionals in nursing homes. The identification of delirium in residents is a fundamental responsibility for nursing home staff.

Trial registration: This review has been registered at Open Science Framework https://doi.org/10.17605/OSF.IO/6ZKM3.

Keywords: Cognitive Dysfunction; Communication; Delirium; Education; Health Personnel; Interprofessional Education; Interprofessional Work; Nurses; Nursing Homes; Realist Review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Steps involved in our realist review (authors’ own illustration)
Fig. 2
Fig. 2
Flow chart for selection of the publications
Fig. 3
Fig. 3
Classification of the publications included in this review according to the PRECEDE model (own illustration) [39]
Fig. 4
Fig. 4
Initial programme theory on educational interventions aimed at improving delirium-specific knowledge among nursing home staff (authors’ own illustration)
See this image and copyright information in PMC

References

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    1. Komici K, Guerra G, Addona F, Fantini C. Delirium in nursing home residents: a narrative review. Healthcare (Basel). 2022;10(8):1544. - PMC - PubMed

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