This research project aims at quantification of the efficacy and (cost-) effectiveness of the Hospital Elder Life Programme (HELP) in the Dutch health care situation. Furthermore, this project will describe and understand the experiences of patients…
ID
Source
Brief title
Condition
- Deliria (incl confusion)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary outcome of the study is the incidence of delirium. Secondary
outcomes include delirium duration (number of days) and severity, length of
stay, care consumption up to three months after admission, experienced quality
of the care process by patients, family, professionals and trained volunteers.
Secondary outcome
Secondary outcomes include delirium duration (number of days) and severity,
length of stay, care consumption up to three months after admission,
experienced quality of the care process by patients, family, professionals and
trained volunteers.
Background summary
In 2005 the Dutch Health Care Inspectorate (IGZ) indicated that in the
Netherlands annually 40.000 to 160.000 hospitalized patients of 70 years and
over suffer from a delirium. From January 2010 delirium incidence in
hospitalized older adults is a quality of care indicator for the Dutch Health
Care Inspectorate (IGZ). Previous research in the USA showed that as a result
of implementation of Hospital Elder Life Program (HELP) the incidence of
delirium can be reduced, as well as its duration and severity. The HELP program
is expected to be cost-saving and improve patient outcomes.
Study objective
This research project aims at quantification of the efficacy and (cost-)
effectiveness of the Hospital Elder Life Programme (HELP) in the Dutch health
care situation. Furthermore, this project will describe and understand the
experiences of patients, family, professionals and trained volunteers.
Study design
A multiple baseline (also known as a stepped-wedge design) will be used to
evaluate the (cost-) effectiveness of the introduction of HELP within the Dutch
health care system. In addition a study with a qualitative design based on the
grounded theory (27; 28) will be carried out.
Intervention
HELP has four unique components:
1. The program provides standardized protocols targeted toward six delirium
risk factors.
2. A multidisciplinary geriatric team, with a central role for the Nurse
Practitioner Elderly Care.
3. Trained volunteers to provide personal, supportive attention to vulnerable
older patients.
4. Personalized interventions that match their changing needs throughout the
course of hospitalization.
Study burden and risks
The incidence of delirium in the included patients will be diagnosed with the
Confusion Assessment Method. After inclusion, nurses will rate their
observations of patients regarding symptoms of delirium at the end of each
shift with the Delirium Observation Screening scale. In patients diagnosed with
delirium according to the CAM, delirium severity will be assessed daily with
the Delirium Rating Scale by the nurse-practitioner. Health related quality of
life (general quality of life, functional well being and emotional wellbeing)
will be measured with the EQ-5D (consisting of the EQ-5D descriptive system and
the EQ VAS) at admission, discharge and after discharge.
No risks are expected for the participating patients. They will receive extra
attention from the volunteers and from the geriatric team.
Heidelberglaan 100
Utrecht 3584 C.X.
NL
Heidelberglaan 100
Utrecht 3584 C.X.
NL
Listed location countries
Age
Inclusion criteria
-Patients are at least 70 years of age
-Have no delirium at the time of admission, and are considered at risk for delirium at admission as determined by the VMS criteria (www.vmsveiligheid.nl)
According to these criteria at least on of the following three questions has to be answered positive to include a patient with an increased risk of delirium:
- Dou you have memory problems?
- During the past 24-hours did you need assistance for your daily self-care?
- Were you confused during earlier hospital admissions or illnesses?
Exclusion criteria
-Older patients in life threatening situations or with a terminal illness at admission.
-Patients with an expected hospital stay of 24 hours or less.
-Patients who are legally incapable of participating or with precluded verbal communication.
-In case of a language barrier.
-Patients with profound aphasia.
-Patients with intubation or respiratory isolation
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL40239.041.12 |