title: Pilot study of a preventive multicomponent nurse intervention to reduce the incidence and severity of delirium in hospitalized older adults: MID-Nurse-P.
abstract: BACKGROUND
  Although multicomponent interventions are the gold standard for delirium management, few nurse-led interventions in Acute Geriatric Units (AGU) are described.
  
  
  OBJECTIVE
  To analyze if a preventive multicomponent non-pharmacologic nurse-led intervention randomized clinical trial (MID-Nurse Study) is feasible (pilot study), and can reduce the incidence, duration, and severity of delirium in hospitalized older adults in an AGU.
  
  
  METHODS
  Parallel-group double-blind randomized clinical trial (pilot Study).
  
  
  METHODS
  AGU Complejo Hospitalario Universitario, Albacete (Spain).
  
  
  METHODS
  50 patients ≥65 years hospitalized in the AGU. Intervention group (IG) 21, control group (CG) 29.
  
  
  METHODS
  After risk factor analysis, all participants in the IG received a daily multicomponent non-pharmacologic intervention (orientation, sensorial deficit, sleep, mobilization, hydration, nutrition, drug chart review, elimination, oxygenation, pain) by the intervention nurses. The CG received usual care.
  
  
  METHODS
  Daily delirium presence with the Confusion Assessment Method (CAM), and severity with the Delirium Rating Scale-Revised-98 (DRS). Outcome measures were delirium incidence, prevalence, severity, and number of days with delirium, mortality, length of stay, use of physical restraint measures, and use of drugs for delirium control.
  
  
  RESULTS
  Mean age 86.5 (48% women). 21 participants presented delirium during hospitalization (14CG and 7 IG). Process, resources, management, and scientific objectives were considered positive, making the study feasible. Delirium prevalence (33.3% vs 48.3%) and incidence (14.3% vs 41.4%; p=0.039) were reduced in the IG compared to CG. Total delirium severity was lower in the IG compared to the CG (35.0 vs 65.0; p=0.040). Mortality was not different between groups (CG 17.2% vs IG 19.0%).
  
  
  CONCLUSIONS
  The MID-Nurse Study is feasible, and a multicomponent nurse-led intervention on patients with delirium in an AGU can reduce delirium prevalence, incidence, and severity. The clinical trial registration number ClinicalTrials.gov ID: NCT02558777.
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario of Albacete, Albacete, Spain.
authors.forename: Almudena
authors.initials: A
authors.lastname: Avendaño-Céspedes
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario of Albacete, Albacete, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: García-Cantos
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario of Albacete, Albacete, Spain.
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: González-Teruel
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario of Albacete, Albacete, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Martínez-García
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario of Albacete, Albacete, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Villarreal-Bocanegra
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario of Albacete, Albacete, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Oliver-Carbonell
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario of Albacete, Albacete, Spain. Electronic address: pabizanda@sescam.jccm.es.
authors.forename: Pedro
authors.initials: P
authors.lastname: Abizanda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D004311:Double-Blind Method; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D010865:Pilot Projects; D057184:Practice Patterns, Nurses'; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D013030:Spain
keywords: Delirium; Hospitalization; Nurse intervention; Pilot clinical trial