Table 1

Stages of delirium prevention sign implementation

StagePlanningAssessmentOutcomeTime required
1There 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
2Engage 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
3Identify 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
4Staff 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
5Develop 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.