Implementation and Evaluation of an Acute Care Multicomponent Intervention for Dementia-Related Behavioral Expressions

J Gerontol Nurs. 2021 Sep;47(9):21-30. doi: 10.3928/00989134-20210803-02. Epub 2021 Sep 1.

Abstract

Despite the high prevalence and negative outcomes associated with poorly managed dementia-related behavioral expressions (BE) during hospitalization, evidence-based interventions for BE management in acute care environments are lacking. To address this gap, we designed, implemented, and evaluated feasibility, utility, and exploratory nurse and patient outcomes associated with a low-cost, nurse-led multicomponent decision support intervention-the Personalized Approach and Targeted Interventions (PROACTIVE) Treatment Approach-which was implemented as a quality improvement program and evaluated with a historical matched comparison group. The intervention was feasibly implemented and improved nurse-sensitive outcomes (stress, confidence), practices (use of nonpharmacological approaches) for BE management, and perceived utility of intervention resources. Patients receiving the PROACTIVE Treatment Approach (N = 40) had higher rates of acetaminophen use, and shorter lengths of stay (N = 40). More rigorous evaluation is needed to better determine optimal implementation strategies and intervention impact. [Journal of Gerontological Nursing, 47(9), 21-30.].

MeSH terms

  • Aged
  • Behavior Therapy
  • Dementia* / therapy
  • Geriatric Nursing*
  • Hospitalization
  • Humans
  • Quality Improvement