School of Nursing
Date of Degree
Doctor of Nursing Practice (DNP)
Beverly K. Lunsford, PhD, RN, FAAN; Karen Whitt, PhD, RN, FNP-C, AGN-BC, FAANP
Background: Often occurring after surgery, or hospitalization, the development of delirium in older adults, initiates a cascade of events culminating in loss of independence, increased morbidity and mortality, and high health care costs (Oh, et al., 2017).
Objective: The purpose of this quality improvement (QI) project was to adapt and implement best practices using HELP for managing older patients with postoperative delirium through the existing 1:1 observation structure and implementing cognitive care strategies. The 1:1 sitter roles and responsibilities were redesigned to include non-pharmacological, multicomponent interventions.
Methods: The QI project used a pre-test post-test intervention design comparing groups before and after the intervention measuring: 1) hours of 1:1 care; 2) number of interventions used; 3) patient length of stay; and 4) use of psychotropic drugs. Data was collected using a standard patient checklist and customized reports.
Results: There was a statistically significant difference in the number of observation hours between the pre-(n=32) and post-intervention (n=33) groups (p< .05), with a mean score of 124.1 versus 62.3 hours respectively; a significant difference in length of stay (p<0.05) with a mean score of 142.6 versus 218.9 hours respectively; a significant difference in the number of medications given (p < .001) with a mean score of 0.9 versus 0 respectively; and a significant difference in the number of interventions utilized (p < .001) with a mean score of 4.7 versus 8 respectively.
Conclusions: This project indicated that the adapted non-pharmacologic HELP model interventions resulted in decreased 1:1 sitter hours, overall length of stay and medication use in postoperative delirious patients.
©2020 Ann Lo Basso. All rights reserved.
Lo Basso, A. (2020). Mitigating Delirium for the Elderly Post-Operatively Without Medication. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/81