Effectiveness of HELP ( Hospitalized Elder Life program) care model to prevent delirium in hospitalized older patients

Determination of delirium incidence in intervention group and comparison with control group

Clinical trials with control group, with parallel, double blind, randomized clinical trials

This study will be conducted on the elderly who are admitted to the internal wards of the Shahid Beheshti hospital in Kashan. Patients are assessed for delirium risk factors by two trainees assessor. Then, based on the initial assessment results, they are under the intervention of the HELP program. At the time of discharge, trained assessors pay for the patient's assessment. Patients in the control group are under routine hospital care. This group is also evaluated at the time of admission and discharge. Patients in both groups are evaluated for delirium in the hospitalization time. In the present study for blinding, Simple Blind method is used. Patients and assessor will be unaware of their study and assumptions.

Inclusion criteria: For this study, older patients (70 years and older) admitted to the hospital are screened for enrollment. Exclusion criteria: The selected patients should be have one of the risk factors for Delirium (visual, hearing, cognitive, sleep disturbance, impaired mobility and dehydration) and have a hospital stay of more than 7 days.

Nursing interventions are designed based on delirium risk factors. Interventions in the intervention group include interventions such as therapeutic activity,early Mobilization, daily orientation, Sleep enhancement, Feeding Assistance/Fluid Repletion, and helping to resolve visual and auditory disorders. Patients in the control group receive routine patient interventions.

incidence of delirium.

Since the delirium risk (moderate and severe) as a confounding variable can lead to imbalance in the intervention and control groups, the Allocation Stratified Block Random method is used in this study. Initially, a sample of 110 (in each group of 55) predicted for this study, based on the risk of delirium, is divided into two groups of moderate (55) and severe (55), then for each group with moderate risk and severe 14 blocks of 4 (2: 2 ratio, each with two controls and two persons) are considered. Determine the number of blocks and layout of individuals in each block using a random number table and determined by someone other than the researcher and those who participate in the sampling. The researcher will be informed by telephone by contacting him about how the block is arranged.

The researcher uses the following methods to reduce contact between patients in both control and intervention groups. 1. Considering that the hospital wards of the sampling site have 4-bed rooms, it is possible to observe and learn the interventions by patients or their carers in the control group so only one patient's room is selected for participation in the study. In case of non-limitation in time for sampling, the researcher can choose a patient to participate in the study in order to prevent the association of patients in the control and intervention groups from each ward. 2. In this study patients will be evaluated and interventions will be conducted by different people. Teaching people who take initial and daily evaluations of patients and those who are selected for interventions is conducted in separate educational sessions.