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17.07.2018 | Original Article

Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium: the DELTA exploratory trial

verfasst von: Asao Ogawa, Yasuyuki Okumura, Daisuke Fujisawa, Hiroyuki Takei, Chiyuki Sasaki, Kei Hirai, Yusuke Kanno, Kensuke Higa, Yasuhiko Ichida, Asuko Sekimoto, Chie Asanuma

Erschienen in: Supportive Care in Cancer | Ausgabe 2/2019

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Abstract

Background

We evaluated whether the DELirium Team Approach (DELTA) program—a systematic management program aimed at screening high-risk groups and preventing delirium—would improve quality of care in patients hospitalized with cancer.

Methods

A retrospective before–after study was conducted during a pre-intervention period (between October 2012 and March 2013) and a post-intervention period (between October 2013 and March 2014) at a Japanese hospital providing specialized treatments for cancer. A total of 4180 inpatients were evaluated before the implementation of the DELTA program and 3797 inpatients were evaluated after implementation.

Results

After program implementation, the incidence of delirium decreased from 7.1 to 4.3% (odds ratio [OR], 0.52; 95% CI, 0.42–0.64). The incidence of adverse events, including falls or self-extubation, also decreased, from 3.5 to 2.6% (OR, 0.71; 95% CI, 0.54–0.92). There was a significant decrease in the prescription of benzodiazepines (OR, 0.79; 95% CI, 0.71–0.87), increase in the level of independence in activities of daily living at discharge (OR, 1.94; 95% CI, 1.11–3.38), and decrease in the length of stay (risk ratio 0.90; 95% CI, 0.90–0.90).

Conclusions

The systematic management program for delirium decreased the incidence of delirium and improved several clinical outcomes. These data suggest that this simple cost-effective program is feasible and implementable as routine care in busy wards.

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Titel: Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium: the DELTA exploratory trial
verfasst von: Asao Ogawa
Yasuyuki Okumura
Daisuke Fujisawa
Hiroyuki Takei
Chiyuki Sasaki
Kei Hirai
Yusuke Kanno
Kensuke Higa
Yasuhiko Ichida
Asuko Sekimoto
Chie Asanuma
Publikationsdatum: 17.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 2/2019
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4341-8

Springer Medizin

Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium: the DELTA exploratory trial