Educational interventions to improve recognition of delirium: a systematic review.

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Delirium is a common and serious condition that is underrecognized in older adults in a variety of healthcare settings. It is poorly recognized because of deficiencies in provider knowledge and its atypical presentation. Early recognition of delirium is warranted to better manage the disease and prevent the adverse outcomes associated with it. The purpose of this article is to review the literature concerning educational interventions focusing on recognition of delirium. The Medline and Cumulative Index to Nursing and Allied Health Literature (CINHAL) databases were searched for studies with specific educational focus in the recognition of delirium, and 26 studies with various designs were identified. The types of interventions used were classified according to the Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model, and outcomes were sorted according to Kirkpatrick's hierarchy. Educational strategies combining predisposing, enabling, and reinforcing factors achieved better results than strategies that included one or two of these components. Studies using predisposing, enabling, and reinforcing strategies together were more often effective in producing changes in staff behavior and participant outcomes. Based on this review, improvements in knowledge and skill alone seem insufficient to favorably influence recognition of delirium. Educational interventions to recognize delirium are most effective when formal teaching is interactive and is combined with strategies including engaging leadership and using clinical pathways and assessment tools. The goal of the current study was to systematically review the published literature to determine the effect of educational interventions on recognition of delirium.





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Yanamadala, Mamata, Darryl Wieland and Mitchell T Heflin (2013). Educational interventions to improve recognition of delirium: a systematic review. J Am Geriatr Soc, 61(11). pp. 1983–1993. 10.1111/jgs.12522 Retrieved from

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Mamata Yanamadala

Associate Professor of Medicine

Mitchell Tod Heflin

Professor of Medicine

I am currently a Professor with Tenure in the Department of Medicine, a Senior Fellow in the Duke Center for the Study of Aging and Human Development, and Associate Dean for Interprofessional Education and Care (IPEC).  My career as a leader in Geriatrics has focused on development, deployment and evaluation of education programs aimed at health professions learners from a variety of disciplines and introduction of innovative models of care with a specific emphasis on community-based and perioperative care of frail older adults.   I served as Geriatrics Fellowship Program Director for 11 years and, over the same span, directed HRSA funded Geriatrics Education Programs at Duke, including our Geriatric Workforce Enhancement Program (GWEP) In that role, I worked with colleagues and community partners to provide IP educational programs in geriatrics and care redesign in primary care practices to improve care for older adults.  Concurrently, I also led the implementation of the Duke Perioperative Optimization of Senior Health (POSH) program and co-directed the VA OAA funded Specialty Care Education Center of Excellence for the VA POSH Program.  In my current role as Associate Dean and Director of the IPEC Center, I am working with educators and clinicians from across the Health System in the design and implementation of educational program aimed at improving our ability to use interprofessional collaborative practice to deliver safe, effective, person-centered care.

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