Journal of Gerontological Nursing
Vol. 30 No. 8 August 2004
By Judy Miller, PhD, RN; Jane Campbell, MSN, RN; Katherine Moore, MSN, RN; Anna Schofield, MS, RN
ABSTRACT
This study tested the Elder Care Supportive Interventions Protocol (ECSIP), which are nursing and family support interventions designed to reduce discomfort and the associated consequences of delirium, impaired physical function, and need for post-hospital care in hospitalized older adults experiencing confusion from delirium or dementia. All adults older than age 74 or older than age 64 if from a nursing home who were admitted to the medical and surgical units of a tertiary care hospital were screened for a diagnosis of dementia, dependence on functional activities, or delirium. The ECSIP includes interventions to prevent and control discomfort, and to promote environmental organization and familiarity. Outcome measures administered within 48 to 72 hours of admission and again within 24 hours prior to discharge included the modified Discomfort Screen - Dementia Alzheimer’s Type, NEECHAM Confusion Scale, and Katz Index of Activities of Daily Living. Patients problems with delirium and impaired physical function improved over hospitalization but were still pronounced at discharge. With the exception of reduced discomfort, there were no significant treatment effects for patients, which is attributed, in part, to inadequate implementation of the ECSIP protocol by nursing staff.
ABOUT THE AUTHORS
Dr. Miller is Professor and Associate Dean, School of Nursing, University of Portland, Portland, Oregon. Ms. Campbell is former Gerontology Clinical Nurse Specialist, University of North Carolina Hospitals, Chapel Hill, North Carolina. Ms. Moore is Director, Office of Admissions and Student Services, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Ms. Schofield is Clinical Nurse Supervisor II, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Funding for this work was provided by the American Nurses Foundation, Institute on Aging at the University of North Carolina, and the School of Nursing (FROG award).
Address correspondence to Judy Miller, PhD, RN, Professor and Associate Dean, School of Nursing, The University of Portland, 5000 North Willamette Boulevard, Portland, OR 97203-5798.
