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Developing delirium best practice: a systematic review of education interventions for healthcare professionals working in inpatient settings

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Key summary points

AbstractSection Aim

To systematically review the literature pertaining to the quality, impact and sustainability of education interventions that focus on improving delirium care by healthcare professionals working in inpatient settings.

AbstractSection Findings

In general, though there was variability in the quality of the identified studies, many were of good quality. Overall, the majority of studies reported improved outcomes post-intervention. There was evidence of impact on patient and healthcare outcomes as well as learners’ behaviour and knowledge. A smaller number of the included studies measured interventional sustainability, with varying results.

AbstractSection Message

The current evidence base supports the use of education as an effective non-pharmacological approach to prevent and treat delirium.

Abstract

Purpose

Understanding the quality of evidence of delirium education studies will assist in designing future education interventions that seek to improve the well-known deficits in delirium prevention, detection and care. The aim of this study is to systematically review the methodological strengths and limitations, as well as the impact of delirium educational interventions for healthcare professionals working in inpatient settings.

Methods

MEDLINE, EMBASE, The Cochrane Library, PsychINFO and CINAHL databases were searched according to PRISMA guidelines for delirium educational interventions in hospital inpatient settings from 2007 to 2017. Identified studies were rated using a standardised quality assessment criteria checklist (Kmet). Reported outcomes were organised by level on the Kirkpatrick model for educational outcomes. The search was repeated in March 2018.

Results

1354 papers were screened, of which 42 studies met the inclusion criteria. Interventions delivered included face-to-face education (n = 34), e-learning (n = 8) and interprofessional education (n = 8). Quality of studies varied in Kmet score (14–96%). There were 17 high-quality studies (Kmet > 80%) and 4 very high-quality studies (Kmet over > 90%). Thirty-eight studies (90%) reported improved outcomes post-intervention. In terms of Kirkpatrick level of educational outcomes, 6 studies were rated at level 1; 13 studies at level 2; 15 studies at level 3; and 8 studies at level 4. Thirteen studies measured intervention sustainability with variable impacts.

Conclusions

Healthcare professional education has benefits for inpatient delirium care, as shown by the high number of good-quality studies and the majority demonstrating improved outcomes post-intervention. The sustainability of educational interventions warrants further exploration.

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Authors and Affiliations

  1. Department of Aged Care Psychiatry, Prince of Wales Hospital, Sydney, Australia

    Anne P. F. Wand

  2. Department of General Medicine, Sutherland Hospital and Community Services, Sydney, Australia

    Song Yuin Lee

  3. Northumbria Healthcare NHS Foundation Trust, North Tyneside, UK

    James Fisher

  4. Discipline of Psychiatry, School of Medicine, University of New South Wales, Sydney, Australia

    Anne P. F. Wand

  5. Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium

    Koen Milisen & Elke Detroyer

  6. Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium

    Koen Milisen & Elke Detroyer

  7. Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada

    Sanjeev Sockalingam

  8. IMPACCT, University of Technology Sydney, Ultimo, Australia

    Meera Agar & Annmarie Hosie

  9. School of Medicine, Griffith University, Gold Coast, Australia

    Andrew Teodorczuk

  10. The Prince Charles Hospital, Metro North Mental Health, Brisbane, Australia

    Andrew Teodorczuk

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Lee, S.Y., Fisher, J., Wand, A.P.F. et al. Developing delirium best practice: a systematic review of education interventions for healthcare professionals working in inpatient settings. Eur Geriatr Med 11, 1–32 (2020). https://doi.org/10.1007/s41999-019-00278-x

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