Meet the team
Audit & Improvement Data Manager
South Eastern Health & Social Care Trust
- Northern Ireland
- Tracy Kane, Service Improvement Lead for Dementia; Danielle Anderson, Clinical Nurse Educator; Danielle Anderson, Clinical Educator
What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?
A successfully tested Delirium Bundle showed increased risk assessment led to prevention and detection of Delirium, which is timely for COVID patients management. Results showed an increase of diagnosis of Delirium (median increase of 4.5 per month), decreased Length of Stay (decrease of 4.2 days) and we started to see a falls reduction. Feedback showed patients and families felt relieved understanding why confusion had worsened, and staff better understood Delirium and how to manage symptoms. We would seek to build on this, spread and embed the Delirium detection and management tool, which will lead to improvement in COVID patients’ care. This project is multi-professional (Clinicians, nursing AHP etc) and includes user and family involvement. Treating a patient with COVID 19 and Delirium can bring on many challenges as isolation, use of PPE, social distancing and lack of involvement from family in care can make it harder to manage and resolve.
What does your project aim to achieve?
The aim of the project is to spread the Delirium Pathway for Prevention and Management of patients into the COVID wards as well as the remainder of the Trust.
By increasing multidisciplinary staff understanding and awareness of Delirium by increased risk screening, prevention strategies, SQID (Single Question in Delirium) use of 4AT assessment and management strategies we aim to:
1. Increase patient risk assessment and promote safety
2. Increase Delirium resolution
3. Decrease patient length of stay in hospital
4. Decrease hospital related patient falls and other hospital assosicated complications
5. Increase communication with patients / service users and Primary Care
The project will also naturally spread to Primary Care ensuring continuity care on discharge.
How will the project be delivered?
A Delirium Working Group will be established to oversee the project, the team will include QI members, Medical, Nursing, AHP’s as well as service users and relatives involvement.
The participating wards will be asked to initially complete the e-learning module and then the Clinical Educators will carry out ward based awareness sessions. Staff knowledge and understanding will be assessed via evaluation and data collected from the HSC e-learning platform.
The bundle will be tested in the wards and continually measured using QI methodology including PDSA to help identify improvements and ideas for change, ensuring all risk are identified and managed.
The pilot showed a decrease in length of stay from 20.5 days to 16.3, saving £28,728 per year. Scale and Spread could result in a potnetial cost saving of £848,340 per year Trustwide.
Engaging with 10,000 voices methodology will ensure that we are listening to the service users/ carers and what matters to them.
How is your project going to share learning?
iDelirium states that “Delirium occurs in up to 25% of Medical; 50% of Surgery and 75% of Intensive Care Patients, it can lead to long-term cognitive decline and hospital associated complications.
Delirium has been identified as a key priority within the SETrust and the Public Health Agency regionally. Learning will be shared locally, regionally and nationally and potentially on global platforms. We plan to share the work at the Annual European Delirium Association Conference.
The Delirium bundle incorporates SIGN 157 guidance and we are happy to share any designed tools or framework with our NHS colleagues.
Improving engagement with family and carers will benefit our patients. COVID has added challenges for our patients in isolation with Delirium, our project will identify and implement robust strategies for maintaining effective communication between staff, patients and relatives. Involvment of patients/relatives in delivering care is well recognised to drive attitudinal change that is essential to deliver best practice.
How you can contribute
- Share Delirium Tools
- Share ways of engaging users
- Share Delirium Success Stories
|1 Nov 2020||Establishment of Delirium Working Group|
|9 Nov 2020||Staff Training and Awarenss in Pilot and designated COVID Wards|
|29 Nov 2020||Band 6 Delirium Co-ordinator in post|
|6 Dec 2020||Commence Bundle Test, weekly team Zooms to look at data|
|7 Mar 2021||Move to a further 5 wards to test bundle|
|8 Aug 2021||Contiue to Spread Delirium Bundle|