E-learning course results in better care for delirium

Researchers from the Netherlands Institute for Health Services Research (NIVEL) found that after completing an e-learning course on delirium, nurses are more likely to use a screening instrument to identify patients at risk of delirium and to take further steps if necessary. They have published their findings in BMC Geriatrics.

One in four older patients (those aged 65 and above) experiences delirium during a hospital admission. As a result, they often have to stay in hospital longer and have an increased risk of death. Delirium is a temporary neuropsychiatric disorder with physiological causes, sometimes referred to as acute confusional state. It might manifest as suspicion, hallucinations, and restlessness. Delirium is a secondary symptom of a physical illness (such as pneumonia), an operation, or dehydration. However, delirium is hard to diagnose, and doctors and nurses often fail to recognise the condition, or disregard it. An e-learning course for nurses has been shown to improve the quality of the care for older patients who might be at risk of delirium. Before taking the e-learning course, the nurses screened half of the patients at risk of delirium; after taking the course, this increased by more than 15%.
The frail elderly
The e-learning course was developed by Noordhoff Health within the framework of the Frail Elderly Project, one of the topics of the National Patient Safety Programme “Prevent harm, work safely” (in Dutch: VMS Veiligheidsprogramma “Voorkom schade, werk veilig”) in Dutch hospitals. This topic is intended to improve the quality of health care for people aged 70 and above. It also contains recommendations for the care of patients with delirium. These recommendations are geared towards earlier detection of delirium by screening for risk factors. The e-learning course is based on the national guidelines for delirium. NIVEL programme director Professor Cordula Wagner: “For hospitals, e-learning has been shown to be a valuable addition to their activities for improving the quality of care for older patients. Considering the vulnerability of this group, they certainly deserve this extra attention.”
The research was carried out in eighteen hospitals. The hospital admissions of a total of 3,273 older patients were included in the study.
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