title: Barriers and facilitators to implementing delirium rounds in a clinical trial across three diverse hospital settings.
abstract: Delirium occurs in more than half of hospitalized older adults with dementia, substantially worsening outcomes. The use of multiple strategies and a local opinion leader, unit champion, has cumulative and lasting effects compared with single-strategy interventions. The purpose of this article is to describe the early barriers and facilitators to rounding with unit champions in a cluster randomized clinical trial in Year 2 of a 5-year trial (5R01NR011042-02). This is a mixed-method study nested within an ongoing multisite cluster-randomized, controlled clinical trial. Descriptive and comparative statistics were collected on N = 192 nursing rounds. Qualitative data were thematically analyzed. On average, rounds lasted 25.54 min (SD = 13.18) and were conducted with the unit champion 64% of the time. This is one of the first studies to systematically address quantitative and qualitative barriers and facilitators to nurse-led delirium rounds, demonstrating the gradual adoption of an intervention in diverse clinical settings.
authors.affiliation: Pennsylvania State University School of Nursing, University Park, USA.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Yevchak
authors.forename: Donna M
authors.initials: DM
authors.lastname: Fick
authors.forename: Jane
authors.initials: J
authors.lastname: McDowell
authors.forename: Todd
authors.initials: T
authors.lastname: Monroe
authors.forename: Kanah
authors.initials: K
authors.lastname: May
authors.forename: Lori
authors.initials: L
authors.lastname: Grove
authors.forename: Ann M
authors.initials: AM
authors.lastname: Kolanowski
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Waller
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Inouye
mesh_terms: D003693:Delirium / Q000175:diagnosis* / Q000451:nursing; D055317:Evidence-Based Practice; D006801:Humans; D008505:Medical Staff, Hospital; D009741:Nursing Staff, Hospital; D056164:Teaching Rounds
keywords: acute care; delirium; evidence-based practice