Background: Patients with delirium and/or dementia are at a significantly increased risk of adverse outcomes and complications in hospital. Many of these adverse outcomes and complications are preventable, and harm could be minimised if delirium and/or dementia is identified early, and risks acted upon. Non-pharmacological approaches for behavioral and psychological symptoms of dementia and delirium (BPSD) management are evidence-based treatment options that do not use medication to manage symptoms and are focused on non-invasive approaches. This study explores the tailored implementation process of evidence-based BPSD management strategies in a multi-site bed-based Transition Care Program (BB-TBP).
Methods: A parallel, mixed method study. Five methods of data collection were used: employee focus groups and interviews; client and support person interviews; pre- and post-implementation surveys; pre- and post-implementation evaluation of adverse events; and pre-and post-implementation audit of risk screening and care plan implementation. Quantitative data was analysed using descriptive statistics. Qualitative data were analysed using deductive content analysis.
Results: Pre-implementation data collection directly informed the design of a tailored implementation strategy, co-designed with employees, to support the use of evidence-based BPSD strategies. An iterative process was required to address ongoing barriers to implementation. The impact of this tailored implementation strategy on the use of evidence-based BPSD strategies and adverse events will be presented.
Discussion: Implementation can be supported by evidence-based, theoretical analysis of barriers and enablers prior to commencement of the implementation process. An iterative process is required to address emerging issues not identified prior to implementation.