Barriers and Facilitators to Implementing Delirium Rounds in a Clinical Trial Across Three Diverse Hospital Settings

Andrea M. Yevchak, Donna M. Fick, Jane McDowell, Todd Monroe, Kanah May, Lori Grove, Ann M. Kolanowski, Jennifer L. Waller, Sharon K. Inouye

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Delirium occurs in more than half of hospitalized older adults with dementia, substantially worsening outcomes. The use of multiple strategies and a local opinion leader, unit champion, has cumulative and lasting effects compared with single-strategy interventions. The purpose of this article is to describe the early barriers and facilitators to rounding with unit champions in a cluster randomized clinical trial in Year 2 of a 5-year trial (5R01NR011042-02). This is a mixed-method study nested within an ongoing multisite cluster-randomized, controlled clinical trial. Descriptive and comparative statistics were collected on N = 192 nursing rounds. Qualitative data were thematically analyzed. On average, rounds lasted 25.54 min (SD = 13.18) and were conducted with the unit champion 64% of the time. This is one of the first studies to systematically address quantitative and qualitative barriers and facilitators to nurse-led delirium rounds, demonstrating the gradual adoption of an intervention in diverse clinical settings.

Original languageEnglish (US)
Pages (from-to)201-215
Number of pages15
JournalClinical Nursing Research
Volume23
Issue number2
DOIs
StatePublished - Apr 2014

Keywords

  • acute care
  • delirium
  • evidence-based practice

ASJC Scopus subject areas

  • General Nursing

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