No longer lost in translation: study protocol for preventing delirium post hip fracture

Abstract

Introduction: Hip fractures are serious injuries commonly experienced by older adults. Delirium has been identified as the most frequent post-operative complication among hospitalized older people, following hip fracture. A quality assurance audit within our hospital demonstrated that delirium screening, prevention and management were not performed routinely or systematically. This study protocol describes an implementation research project which aims to implement and evaluate the effect of an intervention bundle to prevent delirium in patients with hip fracture admitted to an acute orthopaedic ward. Methods: This implementation research project seeks to assess whether the intervention bundle reduces the incidence of delirium in patients with hip fracture patients identified via the use of a validated tool in screening delirium. We will also examine the length of hospital stay, duration of delirium episode and the prevalence of the use of a validated tool to screen delirium. Intervention: Specific intervention strategies, informed by contemporary Behaviour Change Wheel Framework have been selected to address the identified barriers. The final components of the intervention are care pathway, education, audit and feedback, change champions, adaptation of forms and documentation and infographics. Conclusion: This study describes an implementation project which evaluates the effect of a delirium prevention bundle on incidence of delirium in patients with hip fractures. The clinical goal of the delirium prevention care bundle is to bridge the gap between the current and best practice in delirium recognition, prevention and management.