title: Effect Estimation of an Innovative Nursing Intervention to Improve Delirium among Home-Dwelling Older Adults: A Randomized Controlled Pilot Trial.
abstract: OBJECTIVE
  Estimating the effect of a nursing intervention in home-dwelling older adults on the occurrence and course of delirium and concomitant cognitive and functional impairment.
  
  
  METHODS
  A randomized clinical pilot trial using a before/after design was conducted with older patients discharged from hospital who had a medical prescription to receive home care. A total of 51 patients were randomized into the experimental group (EG) and 52 patients into the control group (CG). Besides usual home care, nursing interventions were offered by a geriatric nurse specialist to the EG at 48 h, 72 h, 7 days, 14 days, and 21 days after discharge. All patients were monitored for symptoms of delirium using the Confusion Assessment Method. Cognitive and functional statuses were measured with the Mini-Mental State Examination and the Katz and Lawton Index.
  
  
  RESULTS
  No statistical differences with regard to symptoms of delirium (p = 0.085), cognitive impairment (p = 0.151), and functional status (p = 0.235) were found between the EG and CG at study entry and at 1 month. After adjustment, statistical differences were found in favor of the EG for symptoms of delirium (p = 0.046), cognitive impairment (p = 0.015), and functional status (p = 0.033).
  
  
  CONCLUSIONS
  Nursing interventions to detect delirium at home are feasible and accepted. The nursing interventions produced a promising effect to improve delirium.
authors.affiliation: University of Applied Sciences, Nursing Sciences, La Source, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Henk
authors.initials: H
authors.lastname: Verloo
authors.affiliation: Institut Universitaire de Formation et Recherche en Soins, Lausanne University Hospital, Lausanne, Switzerland ; University of Montreal, Québec, Qué., Canada.
authors.forename: Céline
authors.initials: C
authors.lastname: Goulet
authors.affiliation: Institut Universitaire de Formation et Recherche en Soins, Lausanne University Hospital, Lausanne, Switzerland ; Université Laval, Québec, Qué., Canada.
authors.forename: Diane
authors.initials: D
authors.lastname: Morin
authors.affiliation: Service Universitaire de Psychiatrie de l'Age Avancé, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Armin
authors.initials: A
authors.lastname: von Gunten
keywords: Delirium; Home-dwelling older adults; Nursing intervention; Pilot study; Prevention