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  • Using a general theory of implementation to plan the introduction of delirium prevention for older people in hospital

    Author(s)
    Grealish, Laurie
    Chaboyer, Wendy
    Mudge, Alison
    Simpson, Toni
    Cahill, Margaret
    Todd, Jo-Anne
    Ownsworth, Tamara
    Krug, Maree
    Teodorczuk, Andrew
    Marshall, Andrea P
    Griffith University Author(s)
    Ownsworth, Tamara
    Teodorczuk, Andrew
    Marshall, Andrea
    Chaboyer, Wendy
    Grealish, Laurie A.
    Todd, Jo-anne
    Year published
    2019
    Metadata
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    Abstract
    Aim: Develop an implementation plan for delirium prevention. Background: The use of non‐pharmacological interventions to prevent hospital‐acquired delirium is well established but their implementation has been notoriously difficult to achieve. Systematic analysis of context as part of implementation planning is critical. Methods: Ethnographic study conducted in a 24 bed general medical ward. Eleven patients and family members and 15 health service staff participated through observations, individual interviews, and document review. Inductive analysis was used to generate themes that described enablers and barriers. Results: ...
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    Aim: Develop an implementation plan for delirium prevention. Background: The use of non‐pharmacological interventions to prevent hospital‐acquired delirium is well established but their implementation has been notoriously difficult to achieve. Systematic analysis of context as part of implementation planning is critical. Methods: Ethnographic study conducted in a 24 bed general medical ward. Eleven patients and family members and 15 health service staff participated through observations, individual interviews, and document review. Inductive analysis was used to generate themes that described enablers and barriers. Results: Enablers included a ward culture that embraced safety and placing the person at the centre of care. Barriers were in tension with the enablers and included limited staff knowledge, specialist forms exclusive to the nursing discipline, inflexible ward routines, and frequent disruptions. Conclusions: In addition to standard implementation strategies such as individual education and leadership, implementing delirium prevention requires consideration of team practices, review of policy document design, and identification of outcomes data than can support collaborative reflexive practice. Implications for nursing management: The use of a theory‐informed ethnographic approach exposed tensions that may be otherwise invisible. Understanding the tensions increases the likelihood of implementation success. Using a systematic assessment approach can create a comprehensive implementation plan.
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    Journal Title
    Journal of Nursing Management
    DOI
    https://doi.org/10.1111/jonm.12849
    Note
    This publication has been entered into Griffith Research Online as an Advanced Online Version.
    Subject
    Mental Health Nursing
    Nursing
    General theory of implementation
    acute confusion
    delirium
    ethnography
    older people
    Publication URI
    http://hdl.handle.net/10072/386749
    Collection
    • Journal articles

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