Background: Delirium is a common and preventable condition among older adults in acute hospitals. Early identification and consistent non-pharmacology interventions are often lacking, contributing to prolonged delirium episodes and patient harm. The National Healthcare Group (NHG) introduced a system-wide Delirium Care Bundle to delirium prevention, and early identification across all institutions. As part of this regional initiative, Woodland Health piloted the bundle in Ward A42. Methods: This quality improvement project used a pre-post design over 40 weeks. 13 weeks of baseline data were collected prior to implementation. The Delirium Care Bundle – comprising 4AT screening, Hospital Elder Life Program (HELP) non-pharmacological delirium prevention interventions, supportive care interventions for person with delirium. The delirium care bundle was introduced to the piloted ward in week 10 Implementation was supported by staff training, workflow refinement, visual prompts and weekly audit-feedback cycles. Outcome measures included delirium incidents/week, percentage of patients with delirium, and delirium days/week, analyzed using run charts to identify shifts and special-cause variation. Results: Marked improvements were observed following bundle implementation. Delirium incidents decreased from a baseline maximum of 9 per week to sustained levels of 0-1 incident after Week 15. The percentage of patients with delirium dropped from early peaks of 13-18% to 0-2% in greatest reduction, falling from 28-50 delirium days pre-intervention to 0-2 delirium days after process stabilization. Improvements were maintained for over 12 consecutive weeks, indicating special-cause variation attributable to the intervention. Conclusion: As part of the NGH-wide delirium improvement effort, the pilot at Woodlands Health Ward A42

Authors:
Nur Farhana Ab Razak, Woodlands Health Hospital, Singapore

About the Presenter(s)
Nur Farhana Ab Razak is a Gerontology-trained RN experience in geriatric , subacute and Delirium/BPSD care. Key contributor to specialised unit at TTSH and ANCHOR development at Woodlands Health, supporting compolex older adults and dementia care.

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