Real-world implementation of an electronic medical record-integrated application based on the DELirium Team Approach...

Area of Science:

• Gerontology
• Clinical Medicine
• Health Informatics

Background:

• Delirium is frequently under-recognized in acute care settings.
• Effective interventions are needed to improve delirium detection and management.
• Existing approaches often lack integration into routine clinical workflows.

Purpose of the Study:

• To evaluate the feasibility and exploratory outcomes of a DELirium Team Approach (DELTA) intervention.
• To assess the impact of a DELTA intervention on new-onset delirium rates.
• To explore the integration of a structured assessment tool into electronic medical records.

Main Methods:

• A single-center, before-after study was conducted in an intermediate care unit.
• The intervention involved a 1-hour educational program and an EMR-integrated application.
• New-onset delirium within 48 hours was the primary outcome; process evaluation included application logs and nurse feedback.

Main Results:

• New-onset delirium decreased from 28.9% to 15.3% during the intervention period (p=0.15).
• Patient-level application utilization was 100%, with most nurses completing care plans quickly.
• Nurses reported high rates of assessing pain, dehydration, and constipation, but action rates varied.

Conclusions:

• The DELTA intervention is feasible for integrating structured delirium assessments into acute care.
• Translation of assessments into consistent bedside and multidisciplinary actions remains a challenge.
• Further large-scale controlled studies with objective process measures are recommended.