Oral Presentation Palliative Care Nurses Australia Conference 2022

Driving quality in delirium care: protocol for a study to develop a patient-centred delirium monitoring system in palliative care units (#11)

Annmarie Hosie 1 2 , Meera Agar 2 , Felicity Hawkins 3 4 , Claire Johnson 5 , Paula Moffat 3 , Grace Walpole 6 , Penelope Casey 6 , Angus Cook 4 , Richard Chye 7 , Jacqueline Oehme 8 , Maria Senatore 8 , Claudia Virdun 9 , Mark Pearson 10 , Imogen Featherstone 11 , Peter Lawlor 12 , Shirley Bush 12
  1. University of Notre Dame Australia & St Vincent's Health Network Sydney, Darlinghurst, NSW, Australia
  2. IMPACCT, University of Technology Sydney, Ultimo, NSW, Australia
  3. Bethesda Hospital, Perth, WA
  4. University of Western Australia, Perth, WA
  5. PCOC, University of Wollonging, Wollongong, NSW
  6. Eastern Health, Melbourne, VIC
  7. Sacred Heart Palliative Care Service, Darlinghurst, NSW
  8. St Joseph's Hospital, Auburn, NSW
  9. Queensland University of Technology, Brisbanne, QLD
  10. University of Hull, Hull, United Kingdom
  11. University of York, York, United Kingdom
  12. University of Ottawa, Ottawa, Canada

Background

Delirium is a harmful and distressing acute neurocognitive condition for one in three patients in palliative care inpatient units. Proactive systems for evidence-based delirium care are absent in this setting and innovation is needed to improve clinical recognition, management and outcomes for patients.

 

Aim

To develop a patient-centred delirium monitoring system in palliative care units to improve delirium prevention, detection, root cause treatment and clinical responses to patient’s related distress which integrates Palliative Care Outcomes Collaboration (PCOC) methods with the Delirium Standard.

 

Methods

A two-year exploratory sequential mixed methods study. The project will consult with patients, family, staff and other key stakeholder of four Australian palliative care units to develop and pilot the new delirium monitoring system. Data will be collected via process mapping, clinical audits, semi-structured interviews, case report forms and PCOC methods. Quantitative, qualitative and mixed methods analyses will be used to determine a range of implementation, process and patient outcomes, including the systemic utility (overall feasibility, acceptability and appropriateness) of the new system for wider testing and use by palliative care units to meet the Delirium Standard.

 

Discussion

The project will tackle the complex and long-standing clinical issue of delirium in palliative care, explicitly prioritise patients’ perspectives, and apply methods that are both pragmatic and innovative. The project is a key step forward for quality improvement in delirium care that we look forward to sharing with palliative care nurses in Australia.

 

Funding: The study is funded by a NHMRC Ideas Grant (2021/GNT2010701).