Delirium optimization with volunteer engagement (DOVE): a retrospective study.

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.