Artikel
Developing a complex intervention to prevent delirium during transitional care in older patients: the TRADE study
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Autoren
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Natascha-Elisabeth Denninger
- University of Applied Sciences Rosenheim, Germany; Martin-Luther-University Halle-Wittenberg, Germany
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S. Skudlik
- University of Applied Sciences Rosenheim, Germany
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D. Dallmeier
- Geriatric Research and Geriatric Centre, Ulm University, Ulm, Germany; Boston University, School of Public Health, Boston, United States
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C. Leinert
- Geriatric Research and Geriatric Centre, Ulm University, Ulm, Germany
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S. Brefka
- Geriatric Research and Geriatric Centre, Ulm University, Ulm, Germany
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M. Denkinger
- Institute for Health and Nursing Science, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Germany
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M. Müller
- Centre for Research, Development and Technology Transfer, University of Applied Sciences Rosenheim, Germany; Faculty of Applied Health and Social Sciences, University of Applied Sciences Rosenheim, Germany
| Veröffentlicht: | 5. Juli 2021 |
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Gliederung
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Background: A high incidence and prevalence of delirium is observed in older acute hospital patients. Several factors, like moving from one place to another and the absence of relatives as orientation, are known to increase the risk for delirium.
Objective: The objective of the study is to develop a complex intervention to improve discharge management and to prevent delirium during transitional care in older hospitalized patients.
Design and methods: The TRADE study (TRAnsport und DElirium in older people) was developed based on the recommendations of the UK Medical Research Council for the development and evaluation of complex interventions. Available evidence on non-pharmacological intervention components was evaluated in a systematic search and review. Focus group interviews with involved health professionals were conducted to explore the local discharge and transitional care procedures. Prevalence and determinants of delirium were observed in a prior multicentre observational study. The results of these previous studies were synthesized in a structured expert workshop using nominal consensus technique involving health professionals to get a first draft of the intervention components and an implementation strategy. The draft was elaborated by the research team and consented in an online-delphi-process involving health professionals and patient relatives.
Results and conclusions: The aim of the TRADE study is to engage the patient's family or relatives in the discharge process and to use them as a useful resource in (re-)orienting the patient to transportation and arrival at the new institution or home. The intervention consists of education to the patients (detailed information about the discharge process), their family members or relatives (recommendations for delirium prevention), information materials (flyers, videos and posters) and defined “Dos and Don´ts” that staff should adhere to. The developed intervention will be examined for feasibility and acceptance in a pilot study accompanied by a comprehensive process evaluation. The pandemic COVID-19 and its impact on discharge management, patients and their relatives will also be considered and investigated in the study and process evaluation.
Conflict of interest: The authors declare that they have no conflicts of interest.
Funding: The study is funded by the Joint Federal Committee/Innovation Fund. The study sponsors have no role in any of the decisions regarding planning, conducting or publishing the results.
