Implementing Nurse-Facilitated Person-Centered Care Approaches for Patients With Delirium Superimposed on Dementia in the Acute Care Setting.
Andrea Yevchak, Donna M Fick, Ann M Kolanowski and 4 others
PMID 28661543WHAT IT FOUND
Nurse-led rounds for delirium superimposed on dementia captured person-centered care: checking baseline with family, tailoring activities, using hearing aids, and trying non-drug comfort strategies.
Time and overlooking the patient were barriers.
Key findings
01Rounds documented five person-centered care themes: knowing baseline, knowing interests and values, enhancing sensory abilities to communicate, individualizing cognitive stimulation, and behavioral approaches to comfort and sleep.
02Rounds most often discussed delirium assessment (75%), pharmacological causes (61%), increased physical activity (60%), and sleep routines (53%).
03The main barriers were failure to recognize the patient first and not enough time.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The parent program combined nursing education, decision support, delirium champions, and rounding, so the contribution of any one element cannot be separated. The study did not test whether person-centered care reduced delirium or improved patient outcomes. The rounding form was not designed to capture person-centered care facilitators or barriers, so details may be missing. Research staff were present during rounds, which may have encouraged more person-centered behavior than would occur normally. No follow-up was done after the study, so it is unknown whether these practices persisted.
Declared interests
The parent trial was supported by grant 1R01 NR011042; the supplied text does not report author conflicts of interest.
The easy way to misread this
Do not treat the person-centered care examples as evidence that they prevent or reduce delirium. The study did not test outcomes, and the authors state they cannot determine whether person-centered care was related to delirium occurrence.