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Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/2881
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dc.contributorYates, Marken_US
dc.contributorBail, Kasiaen_US
dc.contributorMacDermott, Seanen_US
dc.contributorSkvarc, Daviden_US
dc.contributorTheobald, Meredithen_US
dc.contributorMorvell, Michelleen_US
dc.contributorJebramek, Jessicaen_US
dc.contributorTebbut, Ianen_US
dc.contributorDraper, Brianen_US
dc.contributorBrodaty, Henryen_US
dc.date.accessioned2025-01-13T02:26:21Z-
dc.date.available2025-01-13T02:26:21Z-
dc.date.issued2024-
dc.identifier.govdoc02893en_US
dc.identifier.urihttp://hdl.handle.net/11054/2881-
dc.descriptionBackground: Hospitalized older patients with cognitive impairment (CI) experience poor outcomes and high rates of hospital acquired complications (HACs). This study investigated the effectiveness of a multimodal hospital CI identification and education program. Method: A prospective stepped-wedge, cross-sectional, continuous-recruitment, hybrid effectiveness-Implementation study was conducted in acute hospitals in four Australian states/territories. The intervention, the Dementia Care in Hospitals Program (DHCP) provided: clinical/ non-clinical hospital staff CI awareness support and education; CI screening for older patients and a bedside alert-the Cognitive Impairment Identifier (CII). The primary outcome was change in the rate of the combined risk of four HACs (urinary tract infection, pneumonia, new onset delirium, pressure injury). Results: Participants were patients aged 65 years and over admitted for 24 h or more over a 12-month period between 2015-2017 (n = 16,789). Of the 11,309 (67.4%) screened, 4,277 (37.8%) had CI. HACs occurred in 27.4% of all screened patients and were three times more likely in patients with CI after controlling for age and sex (RR = 3.03; 95%CI:2.74-3.27). There was no significant change in HAC rate for patients with CI (RR = 1.084; 95%CI: 0.93; 1.26). In the intervention period the raw HAC rate for all screened patients was 27.0%, which when adjusted for age and sex suggested a small reduction overall. However, when adjusted for hospital site, this reduction in HAC risk not statistically significant (RR = 0.968; 95%CI:0.865-1.083). There was considerable interhospital variation in intervention implementation and outcomes which explains the final non-significant effect. Conclusion: For patient with CI the implementation of the DCHP did not result in a reduction in HAC rates. Education for hospital staff regarding cognitive impairment screening, care support, carer engagement and bedside alerts, using the DCHP, can be feasibly implemented in acute hospitals. Reducing high frequency HACs in older hospital patients with CI, warrants further research. Trial registration: The trial was registered retrospectively with the Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615000905561 on 01/09/2015 with 92 patients (0.8% of total sample) recruited in the baseline and none in the intervention before registration submission.en_US
dc.description.provenanceSubmitted by Gemma Siemensma (gemmas@bhs.org.au) on 2024-12-24T00:26:21Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma (gemmas@bhs.org.au) on 2025-01-13T02:26:21Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2025-01-13T02:26:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2024en
dc.titleThe impact of the Dementia Care in Hospitals Program on hospital acquired complications – a non-randomised stepped wedge hybrid effectiveness-implementation study.en_US
dc.typeJournal Articleen_US
dc.type.specifiedArticleen_US
dc.bibliographicCitation.titleBMC Geriatricsen_US
dc.bibliographicCitation.volume24en_US
dc.bibliographicCitation.issue1en_US
dc.bibliographicCitation.stpage986en_US
dc.subject.healththesaurusADVERSE EVENTSen_US
dc.subject.healththesaurusCOGNITIVE IMPAIRMENTen_US
dc.subject.healththesaurusDELIRIUMen_US
dc.subject.healththesaurusEFFECTIVENESSen_US
dc.subject.healththesaurusHOSPITALSen_US
dc.subject.healththesaurusMULTI-MODAL INTERVENTIONSen_US
dc.subject.healththesaurusTRIALen_US
dc.identifier.doihttps://doi.org/10.1186/s12877-024-05548-3en_US
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