tailieunhanh - báo cáo khoa học: " A pragmatic study exploring the prevention of delirium among hospitalized older hip fracture patients: Applying evidence to routine clinical practice using clinical decision support"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A pragmatic study exploring the prevention of delirium among hospitalized older hip fracture patients: Applying evidence to routine clinical practice using clinical decision support | Holroyd-Leduc et al. Implementation Science 2010 5 81 http content 5 1 81 Implementation Science IMPLEMENTATION SCIENCE SHORT REPORT Open Access A pragmatic study exploring the prevention of delirium among hospitalized older hip fracture patients Applying evidence to routine clinical practice using clinical decision support 1 1 1 1 1 Jayna M Holroyd-Leduc Greg A Abelseth Farah Khandwala James L Silvius David B Hogan Heidi N Schmaltz1 Cyril B Frank1 Sharon E Straus2 Abstract Delirium occurs in up to 65 of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive interventions can lower delirium rates. The objective of this study was to implement and evaluate the effectiveness of an evidence-based electronic care pathway which incorporates multi-component delirium strategies among older hip fracture patients. We conducted a pragmatic study using an interrupted time series design in order to evaluate the use and impact of the intervention. The target population was all consenting patients aged 65 years or older admitted with an acute hip fracture to the orthopedic units at two Calgary Alberta hospitals. The primary outcome was delirium rates. Secondary outcomes included length of hospital stay in-hospital falls in-hospital mortality new discharges to long-term care and readmissions. A Durbin Watson test was conducted to test for serial correlation and because no correlation was found Chi-square statistics Wilcoxon test and logistic regression analyses were conducted as appropriate. At study completion focus groups were conducted at each hospital to explore issues around the use of the order set. During the 40-week study period 134 patients were enrolled. The intervention had no effect on the overall delirium rate 33 pre versus 31 post p . However there was a significant interaction between study phase and hospital p . .