Abstract
Background:Interprofessional geriatric consultation teams and multicomponent interventions are established models for delirium care. They are combined in interprofessional consultative delirium team interventions; however, insight into this novel approach is lacking.Objective:To describe the effectiveness and core components of consultation-based interventions for delirium.Method:Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, and ProQuest. Data on core intervention components, outcomes, facilitators, and barriers were extracted.Results:10 studies were included. Core intervention components were systematic delirium screening, ongoing consultation, implementation of non-pharmacologic and pharmacological interventions, and staff education. Of the included studies, 1/6 found a significant reduction in delirium incidence, 1/2 a reduction in delirium duration, and 2/3 found a reduction in falls. Facilitators and barriers to implementation were discussed.Conclusion:There was consistency in team structure and core components, however intervention operationalization and effectiveness varied widely. There is some evidence that this model is effective for reducing delirium and its sequelae.
Highlights
Delirium is an acute change in mental state that develops suddenly, often goes unrecognized, and increases an individual’s risk of adverse events including death, a longer hospital stay, and permanent cognitive decline (Hullick et al, 2018; Piotrowicz et al, 2018)
A broad research question with a clearly articulated scope of inquiry and outcomes of interest was developed to facilitate a comprehensive range of coverage (Levac et al, 2010): “What is the current state of academic literature related to the implementation of inpatient interprofessional consultative delirium teams and their effectiveness for reducing delirium and its related morbidities?”
The interprofessional consultation teams were implemented on a variety of in-hospital units, and most targeted older adults
Summary
Delirium is an acute change in mental state that develops suddenly, often goes unrecognized, and increases an individual’s risk of adverse events including death, a longer hospital stay, and permanent cognitive decline (Hullick et al, 2018; Piotrowicz et al, 2018) It is a highly prevalent condition, seen in 18% to 50% of patients upon admission and incident in 11% to 82% during hospitalization, with older, medically complex populations being the most at-risk (Rubin et al, 2018). Interprofessional geriatric inpatient consultation teams (IGCTs, referred to as inpatient geriatric consultation services, geriatric assessment teams, or geriatric liaison teams) are recognized as a promising model of geriatric care They are mobile teams that conduct comprehensive assessment of older inpatients on non-geriatric wards and provide recommendations for patient care to unit staff (Trogrlić et al, 2015). There is some evidence that this model is effective for reducing delirium and its sequelae
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