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; Cath Bateman; Anne Cumming; Glen Pang; Sigrid Patterson; Anthea Temple

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

Australas J Ageing. 2019 Sep:38 Suppl 2:98-106. doi: 10.1111/ajag.12690.

Authors

Susan Kurrle¹, Cath Bateman¹, Anne Cumming¹, Glen Pang², Sigrid Patterson², Anthea Temple²

Affiliations

¹ Cognitive Decline Partnership Centre, University of Sydney, Sydney, New South Wales, Australia.
² Agency for Clinical Innovation, NSW Ministry of Health, Sydney, New South Wales, Australia.

PMID: 31496063
DOI: 10.1111/ajag.12690

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.

Publication types

Observational Study

MeSH terms

Age Factors
Aging / psychology
Cognition*
Cognitive Dysfunction / diagnosis
Cognitive Dysfunction / psychology
Cognitive Dysfunction / therapy*
Delirium / diagnosis
Delirium / psychology
Delirium / therapy*
Delivery of Health Care, Integrated / organization & administration*
Dementia / diagnosis
Dementia / psychology
Dementia / therapy*
Health Services for the Aged / organization & administration*
Hospitals*
Humans
Inpatients / psychology*
Medical Audit
New South Wales
Patient Care Team / organization & administration
Program Evaluation
Risk Assessment
Risk Factors

Grants and funding

GNT00910000/NHMRC Partnership Centre: Dealing with Cognitive and Related Functional Decline in Older People known as the Cognitive Decline Partnership Centre (CDPC)