S. Hallen, MD R. Babine, APRN, CNS H. Wierman, MD Concepts in Common: An effective interprofessional educational module on delirium for practicing teams in acute care S. Hallen, MD R. Babine, APRN, CNS H. Wierman, MD Geriatric Medicine Maine Medical Center Portland, ME May 2013

Disclaimer slide No conflicts of interest The research reported during this presentation was supported by Dr. Hallen’s HRSA grant (GACA) K01HP20461. The investigators retained full independence in the conduct of this research.

Background Delirium module developed in collaboration: MMC Department of Nursing MMC Geriatric Medicine MaineHealth Education began in October 2011 CAM* nursing policy began in November 2011 IRB exemption was obtained prior to data collection *Innouye Ann Intern Med 1990;Dec 15, 9410-8

*Lakatos, B Psychosomatics 50(3):218-226 HELP Prevent Falls (CAM) Pilot 2008 2009 October Oct Concepts in Common: Delirium Module Development Capstone Project (Delirium E-learn) 2010 2011 2012 Replication of Lakatos* 3 Medicine Units *Lakatos, B Psychosomatics 50(3):218-226

Perceived barriers General lack of knowledge about delirium Unfamiliarity with the CAM Concerns about providers receptivity to communication regarding delirium detection, prevention and management

Concepts in Common Dr. Hallen’s GACA project Interprofessional geriatrics curriculum Targeting practicing teams in the acute setting Goal = better care for hospitalized elders Improving team dynamics via better communication and role recognition Common, accessible medical knowledge

Purpose The purpose of this project was to see if interprofessional education (IPE) can improve delirium knowledge and communication in practicing teams in the acute setting Common knowledge re: delirium, CAM and management Standardized communication (SBAR) Defining roles within a team in caring for patients with delirium

Curriculum Design

Outcomes Knowledge Multiple choice questions Pre-test, post-test given at time of initial education 3-month, 6-month (and 12-month) post-tests were given to a convenience sample of floor staff regardless of attendance Assess team impact of education/utility of other presentation methods (peer-to-peer)

Outcomes Attitude Likert scales were used to measure participant comfort Retrospective questions were used on the immediate post-test to assess pre-education comfort levels Scale 1 = novice (“Not Comfortable”) 5 = expert

Outcomes A participant generated unique identifier was used to track individuals over time Demographic information such as clinical role and years in practice was also collected

Participants 48% 3% 18% 13% 117 individuals took the initial post-test RN 55 48% CNA 3 3% Rehab 22 18% Prescriber 15 13% Other

Team improvement observed! Even though only: 42% tested at 3-months 39% tested at 6-months attended the IPE session

Limitations 3- and 6-month sampling technique (convenience) may have introduced bias High degree of complexity/literacy of pre- and post-tests may have limited ability to test true knowledge

Conclusion IPE is an effective way to improve knowledge of delirium and communication in practicing teams in the acute setting Team improvement was maintained at 3- and 6-months with the greatest gains made by session participants

Acknowledgements Maine Medical Center: Delirium Education Work Group Peg Bradstreet, MS, PMHCNS-BC Valerie Fuller, DNP, ACNP, FNP, GNP Cindy Honess, MSN, ACNS-BC Debra McPherson, MSN, RN Marylou Nesbitt, APRN-BC, AOCN Patricia Todorich, MS, PMHCNS-BC Rhonda Babine, MS, ACNS-BC MaineHealth: Concepts in Common Sharon Foerster, LCSW Sarah Hallen, MD

Heidi Wierman, MD – wiermh@mmc.org Sarah Hallen, MD – halles@mmc.org