Exploring educational interventions to support the management of delirium in older adult care settings; a mixed methods systematic review

Abstract

Objectives: Research highlights the lack of knowledge of assessment and management of delirium in health care staff. A range of educational approaches have been reported to address this deficit. A detailed review of the literature is useful to examine the approaches used and their impact. The objective of this review is to explore the effectiveness and impact on practice of educational interventions for the management of delirium in care settings for older adults. Method: A mixed methods systematic review was conducted, adopting the PRISMA reporting guidelines. Four databases were searched: CINAHL, PsychInfo, Medline and ProQuest. The articles were screened independently for inclusion and selected studies were quality appraised using MMAT. Narrative synthesis was conducted on quantitative studies and thematic analysis on qualitative studies (total n = 22). Findings: Most studies found some improvement in knowledge of delirium after intervention. Improvements were noted in screening and assessment practice, although questions remained over screening competence. In terms of identifying facilitators for education, two main themes were developed including ‘active learning’ and ‘change facilitators and inhibitors’. Conclusion: Whilst interventions were successful in increasing knowledge, there is still work to be done in increasing screening competence and incorporating active learning strategies into education about delirium.