Improving the etection, ssessment, anagement and revention of elirium in Hospices (the DAMPen-D study): Feasibility study of a flexible and scalable implementation strategy to deliver guideline-adherent delirium care.

Background: Delirium is a complex condition, stressful for all involved. Although highly prevalent in palliative care settings, it remains underdiagnosed and associated with poor outcomes. Guideline-adherent delirium care may improve its detection, assessment and management.

'It's tough. It is hard': A qualitative interview study of staff and volunteers caring for hospice in-patients with delirium.

Background: Delirium is a distressing condition often experienced by hospice in-patients. Increased understanding of current multidisciplinary care of delirium is needed to develop interventions in this setting.

Aim(s): To explore hospice staff and volunteers' practice, its influences and what may need to change to improve hospice delirium care.

Improving the Detection, Assessment, Management and Prevention of Delirium in Hospices (the DAMPen-D study): protocol for a co-design and feasibility study of a flexible and scalable implementation strategy to deliver guideline-adherent delirium care.

Introduction: Delirium is a complex condition in which altered mental state and cognition causes severe distress and poor clinical outcomes for patients and families, anxiety and stress for the health professionals and support staff providing care, and higher care costs. Hospice patients are at high risk of developing delirium, but there is significant variation in care delivery. The primary objective of this study is to demonstrate the feasibility of an implementation strategy (designed to help deliver good practice delirium guidelines), participant recruitment and data collection.

Risk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis.

Background: Delirium is common and distressing for patients receiving palliative care. Interventions targetting modifiable risk factors in other settings have been shown to prevent delirium. Research on delirium risk factors in palliative care can inform context-specific risk-reduction interventions.

Outcomes and measures of delirium interventional studies in palliative care to inform a core outcome set: A systematic review.

Background: Trials of interventions for delirium in various patient populations report disparate outcomes and measures but little is known about those used in palliative care trials. A core outcome set promotes consistency of outcome selection and measurement.

Aim: To inform core outcome set development by examining outcomes, their definitions, measures and time-points in published palliative care studies of delirium prevention or treatment delirium interventions.

The experience of delirium in palliative care settings for patients, family, clinicians and volunteers: A qualitative systematic review and thematic synthesis.

Background: Delirium is common in palliative care settings and is distressing for patients, their families and clinicians. To develop effective interventions, we need first to understand current delirium care in this setting.

Aim: To understand patient, family, clinicians' and volunteers' experience of delirium and its care in palliative care contexts.

Delirium screening practice in specialist palliative care units: a survey.

Objectives: Delirium is common and distressing in palliative care settings. This survey aims to describe current practice regarding delirium identification in specialist palliative care units (SPCU), such as inpatient hospices, in the UK.

Methods: An 18-item anonymous online survey was distributed by Hospice UK to their network of clinical leads (n=223), and to their research mailing list (n=228).

Inclusion, characteristics and outcomes of people requiring palliative care in studies of non-pharmacological interventions for delirium: A systematic review.

Background: Delirium is common, distressing, serious and under-researched in specialist palliative care settings.

Objectives: To examine whether people requiring palliative care were included in non-pharmacological delirium intervention studies in inpatient settings, how they were characterised and what their outcomes were.

Design: Systematic review (PROSPERO 2017 CRD42017062178).

Can service integration work for universal health coverage? Evidence from around the globe.

Universal health coverage (UHC) is at the heart of the new 2030 Agenda for Sustainable Development. Health service integration is seen by World Health Organization as an essential requirement to achieve UHC. However, to date the debate on service integration has focused on perceived benefits rather than empirical impact.

Care home staff can detect the difference between delirium, dementia and depression.

Prevention of delirium is an important part of looking after care home residents, however, it can be difficult to detect, especially in those who have dementia. This article explores the perceptions and experiences of care home staff integrating delirium prevention activity in their everyday work. As part of the Stop delirium! feasibility study interviews were carried out and when they were analysed five themes were identified: triggers and knowledge; detection and observation; effect of closest contact; changes in management of care; and communication and teamwork to overcome difficulties.

Do integrated record systems lead to integrated services? An observational study of a multi-professional system in a diabetes service.

Purpose: There are few opportunities to study the use of integrated electronic health record (EHR) systems, where single patient records are used by a number of health care staff. The purpose of the study was to understand how an integrated electronic health record system was used by health care staff in the treatment and management of diabetes patients. The investigation was focused on the interface between the primary and secondary care services which patients access for their diabetes care.

Stop Delirium! A complex intervention to prevent delirium in care homes: a mixed-methods feasibility study.

Background: delirium is likely to be particularly common in care homes, given the clustering of known risk factors in these settings. Preventing delirium should result in significant benefits, including better quality of care and improved outcomes for residents.

Objective: to test the feasibility of 'Stop Delirium!', an intervention to prevent delirium in care homes for older people, and to optimise parameters to inform the design of a future trial evaluation.

An intervention to reduce delirium in care homes.

This article describes delirium and explains why its prevention is important. An enhanced educational package that was developed with care home staff to prevent delirium is outlined. The challenges and successes of the project are highlighted.