Abstract
Introduction
Delirium affects up to 50% of older patients (aged over 65 years) in hospital and is associated with serious consequences including greater morbidity and mortality, longer hospital stays with consequent hospital acquired complications, and an increased likelihood of hospital readmission. Early recognition prompting effective management is critical in improving outcomes for patients with delirium.
Methods
This QIP was conducted amongst Foundation Year 1 doctors (FY1) working across all wards in a busy district general hospital to improve knowledge of delirium through educational interventions covering definitions, classification, assessment tools, management, predisposing factors, and prognosis. Baseline knowledge was assessed using a multiple-choice questionnaire with re-assessment following a face-to-face teaching presentation, and electronic poster. A follow-up survey assessing participant's perceptions toward delirium management was also conducted.
Results
Prior to intervention, an average of 25% of FY1 doctors selected the correct answer in assessment. This rose to 86% post-presentation and remained at 83% following circulation of the poster. Breakdown of results demonstrated a marked improvement of 59% of clinicians being able to define, and 95% able to classify delirium. An improvement of 51% was noted in the knowledge of assessment tools and a notable 94% in knowledge of pre-disposing factors. Baseline knowledge of prognosis was excellent at 89% and a 2% reduction was noted following interventions. 81% of clinicians felt their knowledge of delirium strongly improved following interventions and 60% strongly agreed to feeling more confident in managing delirium.
Conclusion
The implementation of two distinct educational interventions, through plan-do-study-act cycles, were successful in improving knowledge of delirium. Targeted teaching significantly improved knowledge and understanding, and a follow-up educational poster was a useful tool in promoting knowledge retention and reinforcement. These findings support the strategy of implementing focussed delirium education early in medical training as an avenue to improve patient care.