Recruitment of volunteers to improve vitality in the elderly: the REVIVE study.
BACKGROUND
Delirium is a common problem for frail, older patients in hospital and a marker of poor outcome and mortality. The aim of this study was to test a volunteer-mediated delirium prevention programme for efficacy, cost-effectiveness and sustainability on an Australian geriatric ward.


METHODS
Two controlled before-and-after studies were conducted. In study 1, 37 patients (>70 years, admitted to the geriatric wards) were enrolled during 5 months in 2003 for intensive individual study. Twenty-one patients received usual care and 16 patients received the volunteer-mediated intervention of daily orientation, therapeutic activities, feeding and hydration assistance, vision and hearing protocols. In study 2, we examined the effects of a general implementation for the whole department by measuring use of assistants in nursing, who were employed for individual nursing of delirious patients.


RESULTS
In study 1, we found a lower incidence (intervention vs control, 6.3% vs 38%; P = 0.032) and lower severity of delirium (1.2 vs 5.1; P = 0.045). There was a trend towards decreased duration of delirium (5.0 vs 12.5; P = 0.64). In study 2, use of assistants in nursing was reduced by 314 h per month suggesting a total annual saving of 129,186 Australian dollars for the hospital.


CONCLUSIONS
The programme prevents delirium and improves outcomes for elderly inpatients. Cost-effectiveness supports the continuation of the programme and extension to other geriatric units.
Caplan
G A
GA
Geriatric Medicine, Prince of Wales Hospital, Sydney, NSW, Australia.
Harper
E L
EL
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003693:Delirium / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D014838:Volunteers