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Войти в исследования The Gerontologist · 2025
Delirium optimization with volunteer engagement (DOVE): a retrospective study.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Webb Kevin L, Pruter Wyatt W, Boyapati Renu B, Kaster Laura M, Fischer Karen M, Chambers Stephanie P, Pagali Sandeep R
Аннотация
BACKGROUND AND OBJECTIVES: To assess the efficacy of a local volunteer program, delirium optimization with volunteer engagement (DOVE), in preventing in-hospital delirium.
RESEARCH DESIGN AND METHODS: Between February 2023 and June 2024, volunteers provided structured interventions to patients at risk for delirium, as identified by the Delirium Risk Assessment (DRA) score. Interventions are humanities-based and included sensory aide assistance, completion of "get to know me" forms, and conversation. Data were retrospectively acquired from electronic health records and compared to a control cohort from another medical unit. Delirium occurrence was captured when the nursing confusion assessment method (CAM) documentation was positive, or a clinician documented delirium diagnoses. Cohorts were matched 1:2 (DOVE vs Control) by age, gender, DRA score, month/year of admission, and length of hospital stay.
RESULTS: A total of 168 patients received interventions by DOVE volunteers, of which 139 were matched with 261 controls. In-hospital delirium occurrence was lower in the DOVE cohort compared to the control cohort (46.8% vs 56.7%; p = .015). Conditional logistic regressions demonstrated a lower odds ratio (OR) for delirium occurrence, 0.55 (95% confidence interval [CI]; 0.34-0.89; p = .015) associated with DOVE intervention. Subgroup analyses of delirium occurrence among patients with DRA score of 3-4 demonstrated an OR of 0.56 (95% CI; 0.31-1.01; p = .053) between the DOVE and control cohorts.
DISCUSSION AND IMPLICATIONS: In-hospital delirium occurrence was ∼10% lower among DOVE cohort patients. This humanities-based intervention offers a feasible strategy, particularly during times of staffing shortages, and should be considered for broader implementation across healthcare institutions.
RESEARCH DESIGN AND METHODS: Between February 2023 and June 2024, volunteers provided structured interventions to patients at risk for delirium, as identified by the Delirium Risk Assessment (DRA) score. Interventions are humanities-based and included sensory aide assistance, completion of "get to know me" forms, and conversation. Data were retrospectively acquired from electronic health records and compared to a control cohort from another medical unit. Delirium occurrence was captured when the nursing confusion assessment method (CAM) documentation was positive, or a clinician documented delirium diagnoses. Cohorts were matched 1:2 (DOVE vs Control) by age, gender, DRA score, month/year of admission, and length of hospital stay.
RESULTS: A total of 168 patients received interventions by DOVE volunteers, of which 139 were matched with 261 controls. In-hospital delirium occurrence was lower in the DOVE cohort compared to the control cohort (46.8% vs 56.7%; p = .015). Conditional logistic regressions demonstrated a lower odds ratio (OR) for delirium occurrence, 0.55 (95% confidence interval [CI]; 0.34-0.89; p = .015) associated with DOVE intervention. Subgroup analyses of delirium occurrence among patients with DRA score of 3-4 demonstrated an OR of 0.56 (95% CI; 0.31-1.01; p = .053) between the DOVE and control cohorts.
DISCUSSION AND IMPLICATIONS: In-hospital delirium occurrence was ∼10% lower among DOVE cohort patients. This humanities-based intervention offers a feasible strategy, particularly during times of staffing shortages, and should be considered for broader implementation across healthcare institutions.