Abstract
To evaluate the implementation of a model of care known as the Confused Hospitalised Older Persons (CHOPs) program to improve recognition, assessment and management of older persons with cognitive impairment (delirium and/or dementia) admitted to acute hospitals. The model of care was implemented in six selected hospitals across New South Wales. Pre- and postimplementation medical record audits, environmental audits, and staff knowledge and care confidence surveys were performed. Interviews with clinical leads postimplementation identified enablers and barriers. There were significant increases in cognitive screening within 24hours (OR=3.32 [2.50-4.91]), delirium risk identification (OR=4.04 [2.89-5.64]), assessment of cognitive impairment (OR=2.55 [1.90-3.43]) and interaction with families (OR=2.81 [2.09-3.79]). Staff education and care confidence were improved, and positive environmental changes occurred in all hospitals. Barriers and enablers to implementation were identified. The CHOPs program improved identification, risk assessment and management of cognitive impairment in older hospitalised patients.
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