Deploying Interventions to Prevent Delirium and Improve the Care Experience for Patients with Dementia

Grant Application

Amy Kowinsky, RD LDN, Daniel Cevetello, DO, and Elizabeth Mohan, MD, UPMC Mercy and UPMC St. Margaret

 

Proposed Innovation

Delirium involves the sudden onset of confusion and reduced ability to focus, shift, or sustain attention. It can affect as many as 50 percent of geriatric patients. Dementia patients have an even greater risk for developing delirium in the hospital, because of their unique care needs.

Delirium costs our country nearly $182 billion annually. For patients and their families the cost is even greater, often causing increased illness, functional losses that are never regained, and even death. Through this project, interventions will be used to prevent delirium and better manage the care experience of dementia patients by providing safer, more patient-centered care for older hospitalized patients — as well as reduce overall health care costs.

 

Improvements in Action

In this two-pronged innovation project funded by the Beckwith Institute, non-drug interventions will be used to prevent delirium in two different populations:

At UPMC St. Margaret, geriatric patients identified at risk for developing delirium will be given a Delirium Toolbox equipped with a variety of tools and activities designed to engage and stimulate patients during hospitalization. It will help patients become better oriented to their surroundings, address any hearing or visual problems, and promote better sleep.

At UPMC Mercy, dementia patients will receive additional daytime supervision and stimulation at a Dementia Activities Center. Here, patients will participate in a variety of activities focused on keeping them engaged and safe while ensuring that they eat, drink, and walk. Goals include reducing the occurrence of delirium; improving family and staff perceptions of care; preventing hospital-acquired conditions; maintaining functional status; and decreasing length of stay.

 

Results – In Progress

This project aims to decrease the overall incidence of delirium for older patients at UPMC St. Margaret, and patients with dementia at UPMC Mercy. The Dementia Activities Center will use a variety of criteria to evaluate its impact, including use by patients, length of stay, food intake, and staff perceptions.