Improving caregivers and physicians understanding about delirium in patients aged 75 and over in a non-geriatric inpatient unit: a study before-and-after a multimodal educational intervention

Abstract

Abstract Background: Delirium is a common geriatric syndrome which has a poor prognosis if not managed rapidly. Our main objective was to improve the knowledge of a non-geriatric care team concerning delirium in the older patients through a multimodal educational intervention in an Infectious Diseases Department. Materials & Methods: We carried out a monocentric descriptive cohort study in an infectious diseases unit (France), with a retrospective phase (March to May 2021) and a prospective phase (October to December 2021). The multimodal educational intervention on delirium was conducted in September 2021. The primary endpoint was the difference in the percentage of correct responses from the Delirium Knowledge Questionnaire (DKQ) before and after the intervention. The secondary objectives concerned the progression of the knowledge of the Confusion Assessment Method (CAM), the different forms of delirium and the impact of the intervention on the frequency of diagnosis of delirium, on the patient care pathway and on the quality of care. Results: The rate of DKQ correct answers of the 24 health caregivers included in the study improved significantly(89.3% vs 84.7%, p=0.02). The CAM was known by 1/5th of caregivers before the intervention and reached 83.3% after training. More than half of the caregivers were aware of all 3 forms of delirium after training. The frequency of delirium diagnosis did not change after the intervention. Prescription of physiotherapy became more frequent, while the use of the mobile geriatric unit or the scheduling of remote geriatric consultations did not change. Conclusion: Our multi-modal educational intervention resulted in an improvement in caregivers' knowledge of the topic of delirium. Almost three quarters of caregivershad a knowledge about the CAM. Given the frequency of diagnosis and the severity and costs associated with the occurrence of delirium, it seems of major interest to integrate initial and ongoing training for carers on delirium.