Stages of delirium prevention sign implementation
| Stage | Planning | Assessment | Outcome | Time required |
| 1 | There is a gap in the delivery of non-pharmacological interventions to orthopaedic patients. Survey nurses and allied health on E2 to determine perspectives. | 85% (34/40) said it would useful to have a bedside tool to help prompt use of non-pharmacological interventions. | Confirmed this as a true problem worth addressing. Identified methods to help staff implement interventions. | 2 weeks |
| 2 | Engage members of ‘Delirium Research Group’ and seek opinions from clinical staff and nurse specialists. | Sign developed to include interventions based on the six main components of the HELP programme. Concerns raised re: buy-in of nurses with competing priorities. | Provided the necessary training on sign use and engaged nurses throughout improvement process. | 2 months |
| 3 | Identify nurse champion on unit and develop educational poster and training session materials. | 90% of nursing staff on E2 participated in 10 min training sessions during their routine daily staff safety huddles. | Staff trained and signs ready to be placed in target rooms. | 1 month |
| 4 | Staff will complete all sign components for patients admitted to the orthopaedic ward. Audit signs and conduct focus groups to determine areas for improvement. | Audits show just 47% of signs being used. Focus groups demonstrate issues related to marker availability, and sign adherence to the wall as barriers to completion. | Installed magnetic strips to secure signs to wall. Purchased markers to increase availability on unit. | 3 months |
| 5 | Develop family survey to evaluate their perspectives and experiences with the sign. | 85% (17/20) found the sign easy to understand. Only 50% (10/20) thought it helped them care for their relative. | Identify methods to increase family engagement with sign. Consider patient/family input in future design changes. | 2 weeks |
HELP, Hospital Elder Life Programme.