Improving The Care Management of Delirium In Hospitalized Older Adults: Impact Of Education On Hospital Aides In The Role As A Sitter
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Abstract
Delirium commonly occurs in hospitalized older adults (Hshieh, Yang, Gartaganis, Yue, & Inouye, 2018) and is associated with negative physical and emotional patient outcomes. As one of several hospital team members involved in the management of care for an older adult with delirium, a hospital aide (HA) is often relied upon to provide direct patient care in the role as asitter (Collela, et al., 2017). Yet, many hospital aides have not received training about delirium, its associated symptoms, or appropriate interventions (Carr, 2013; Solimine et al., 2018). This Doctor of Nursing Practice improvement project sought to determine if an educational session, based on the theoretical framework of Albert Bandura's Social Learning Theory (Bandura, 1969), increased HA knowledge and delirium behavior(s) recognition, as well as accurate performance in the delivery of care to patients with delirium. There were several positive results from the education session on delirium. First, there was an improvement in HA knowledge of delirium as noted by an increase in mean scores from the pre-test compared to the post-test. Secondly, HAs demonstrated retention and reproduction of their gained knowledge at the bedside by accurately performing care of patients with delirium at the bedside as scored by the Observation Rubric and in detection of delirium symptoms on the Sour Seven Detection Tool. Themes from the qualitative data were consistent with the reproduction of knowledge in the role of the role of the sitter at the bedside. The education session also contributed to increased confidence in carrying out important responsibilities as a sitter such as observation and communication. In carrying out these responsibilities, the HAs had less apprehension in caring for patients with delirium and could apply skills, knowledge, and techniques in helping and caring for older adults. There was also a clearer definition of how the HAs were valued as important contributors to the interdisciplinary team (IDT). By using an interactive and engaging educational framework such as social learning theory (SLT), HAs can demonstrate accuracy of knowledge immediately after an educational session on delirium as well as reproduce and apply knowledge in practice at the bedside in the role as a sitter. Previous to this project, the role of the HA as a sitter was underutilized, however this project illuminated the valuable contribution of HAs augmenting the IDT.
Description
Practice Project
Citation
Publisher
Hawaii Pacific University