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Effects of an interdisciplinary nurse-led Delirium Prevention and Management Program (DPMP) on nursing workload : a pilot study

Pretto, Manuela and Spirig, Rebecca and Milisen, Koen and Degeest, Sabina and Regazzoni, Pietro and Hasemann, Wolfgang. (2009) Effects of an interdisciplinary nurse-led Delirium Prevention and Management Program (DPMP) on nursing workload : a pilot study. International journal of nursing studies, Vol. 46. pp. 804-812.

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Official URL: http://edoc.unibas.ch/dok/A6004251

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Abstract

BACKGROUND: Delirium in elderly hip-fracture patients is common and results in negative patient outcomes and increased nursing workload. DESIGN AND OBJECTIVE: The study was part of an evaluation of the interdisciplinary nurse-led Delirium Prevention and Management Program (DPMP) in a Swiss university hospital. Nursing workload was compared before and after implementing the program, using a quasi-experimental design. PARTICIPANTS: Included were 200 patients who were 65 years of age or older, recovering from hip-fracture surgery on a trauma ward (intervention) or on the other surgery wards. METHODS: Workload was compared before and after implementing the program on the trauma ward and was also compared on other surgery wards. Nursing workload for each patient was evaluated by means of data obtained from the nursing workload management system. Data were collected in a 4-month timeframe in 2004 and 2005 respectively. Differences for workload in total and workload for day, evening, and night shifts on postoperative days 1-5 were calculated, controlled by co-morbidity. Subgroup analysis was performed for patients categorized by nurses as 'confused'. RESULTS: Total workload decreased slightly from Year 1 to 2 by 6.4% and 4.2% for patients on the trauma ward and other surgery wards. However, workload during night shifts on the trauma ward decreased significantly by 22% (p=.004), while there was not a significant change on the other surgery wards. Sub-analyses for 'confused' patients found that the workload at night on the trauma ward decreased significantly by 23% (p=.01), while it did not change significantly on other surgery wards. Higher co-morbidity and nurses' labelling patients as 'confused' were associated with increased workload (p>.001). CONCLUSIONS: After implementing the program, decreased workload at night was found on the trauma ward. Delirium was detected and treated more quickly which led to less care needed at night. The reason for the slight drop workload on all wards requires further investigation.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Ehemalige Einheiten Public Health > Klinische Pflegewissenschaft (Spirig)
UniBasel Contributors:Spirig, Rebecca
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Pergamon
ISSN:0020-7489
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 May 2013 09:21
Deposited On:24 May 2013 08:59

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