%0 Journal Article
%T Improving the Detection, Assessment, Management and Prevention of Delirium in Hospices (the DAMPen-D study): Feasibility study of a flexible and scalable implementation strategy to deliver guideline-adherent delirium care.
%A Jackson GP
%A Jackson CE
%A Boland JW
%A Featherstone I
%A Huang C
%A Ogden M
%A Sartain K
%A Siddiqi N
%A Twiddy M
%A Pearson M
%A Johnson MJ
%J Palliat Med
%V 38
%N 4
%D 2024 Apr
%M 38634231
%F 5.713
%R 10.1177/02692163241236325
%X <B>UNASSIGNED: </B>Delirium is a complex condition, stressful for all involved. Although highly prevalent in palliative care settings, it remains underdiagnosed and associated with poor outcomes. Guideline-adherent delirium care may improve its detection, assessment and management.<BR><B>UNASSIGNED: </B>To inform a future definitive study that tests whether an implementation strategy designed to improve guideline-adherent delirium care in palliative care settings improves patient outcomes (reduced proportion of in-patient days with delirium).<BR><B>UNASSIGNED: </B>With Patient Involvement members, we conducted a feasibility study to assess the acceptability of and engagement with the implementation strategy by hospice staff (intervention), and whether clinical record data collection of process (e.g. guideline-adherent delirium care) and clinical outcomes (evidence of delirium using a validated chart-based instrument;) pre- and 12-weeks post-implementation of the intervention would be possible.<BR><B>UNASSIGNED: </B>In-patient admissions in three English hospices.<BR><B>UNASSIGNED: </B>Between June 2021 and December 2022, clinical record data were extracted from 300 consecutive admissions. Despite data collection during COVID-19, target clinical record data collection (n = 300) was achieved. Approximately two-thirds of patients had a delirium episode during in-patient stay at both timepoints. A 6% absolute reduction in proportion of delirium days in those with a delirium episode was observed. Post-implementation improvements in guideline-adherent metrics include: clinical delirium diagnosis 15%-28%; delirium risk assessment 0%-16%; screening on admission 7%-35%.<BR><B>UNASSIGNED: </B>Collection of data on delirium outcomes and guideline-adherence from clinical records is feasible. The signal of patient benefit supports formal evaluation in a large-scale study.