Abstrakt

Teams against delirium: A project in a nursing home "Cialdini" in Modena

B Manni*, R Degesu, P Zucchi, A Fabbo

Delirium, an acute disorder of attention and cognition, is a serious, costly, underrecognized and often fatal condition for seniors. Given its typically complex multifactorial etiology, multicomponent nonpharmacologic risk factor approaches have proven to be the most effective strategy for prevention. The aim of this case-control study was to examine differences in delirium detection and management in a NH between two care units (Unit A and B), of which only Unit B has benefited from multiprofessional staff training on delirium detection, diagnosis and nonpharmacological management. In particular, the measured outcomes were the differences between clinical negative outcome (mortality rate, number of hospital admissions, number of falls, and presence of incontinence or pressure ulcers) between the two units. Results: There were no significant differences between groups (Unit A: 52 elderly of which 31 affected by moderate and severe dementia and Unit B: 61 elderly of whom 31 affected by moderate to severe dementia) regarding: sex distribution, rate of moderate and severe dementia, age and comorbidity, but the two groups differed by the number of medications employed. After staff training only in Unit B were detected 17 case of delirium underlying most urinary infection (23%) and pain (29%). Early detection and non-pharmacological multicomponent manage in Unit B was able to reduce negative outcomes, in particularly fall and incontinence, more than in Unit A. After Delirium manifestation, none a specific but a multicomponent non-pharmacological approach reduced duration of Delirium. A skilled interdisciplinary team can improve diagnosis and prevent Delirium. Continuos trainig is a key-point to join protocols.