Delirium Prevention
Lesson Progress
0% Complete
Multicomponent nonpharmacologic delirium prevention programs ↓ incident delirium ~30%
How is Delirium Prevented?
Hospital Elder Life Program (HELP)
The original evidence-based approach to delirium prevention in hospitalized patients:
- Uses staff, patients, caregivers, and volunteers
- Includes orientation, sleep enhancement, early mobilization, vision and hearing adaptation, fluid repletion and feeding assistance, and pain management
- Reduces incident delirium and inpatient falls
- Can be adapted to ED setting
NOTE
To date, research studies evaluated delirium prevention programs have only occurred in the inpatient setting, however, there are elements of these programs that can be adapted for use in the ED setting.
Siddiqi N, et al. Cochrane Database Syst Rev. 2016;3:CD005563
- Multicomponent interventions reduce the incidence of delirium as compared to usual care (RR, 0.69; 95% CI, 0.59–0.81)
- Similar results in medical and surgical inpatient settings
- Multicomponent intervention effectiveness remains uncertain in patients with dementia
Hshieh TT, et al. Am J Geriatr Psychiatry. 2018;26(10):1015–1033
- Original HELP program debuted in 1993
- Has since been implemented in medical, neurological, surgical, intensive care, postacute, and long-term care settings
- Meta-analysis for delirium reduction: OR, 0.47 (95% CI, 0.37–0.59)
- Meta-analysis for fall reduction: OR, 0.58 (95% CI, 0.35–0.95)
Sanon M, et al. J Am Geriatr Soc. 2014;62(2):365–370
- Description of an ED-based volunteer program incorporating many principles of the HELP program
References
Hshieh TT, et al. Am J Geriatr Psychiatry. 2018;26(10):1015–1033.
Sanon M, et al. J Am Geriatr Soc. 2014;62(2):365–370.
Siddiqi N, et al. Cochrane Database Syst Rev. 2016;3:CD005563.
Abbreviations
CI, confidence interval
HELP, Hospital Elder Life Program
OR, overall risk
RR, relative risk