| Original HELP protocols | HELP in this study |
---|---|---|
Goals | Maintain physical and cognitive functioning, maximize independence at discharge, assist with the transition from hospital to home, prevent unplanned readmission. | No adaptation |
Screening | ELS within 48 hours | NP within 36 hours |
Inclusion criteria | 70 years and over, at least one risk factor for delirium present | 70 years and over at risk for delirium according to Dutch Safety Management Program |
Exclusion criteria | intubation or respiratory isolation, aphasia, terminally ill, severe dementia, respiratory isolation, expected discharge within 48 hours after admission. | Same exclusion criteria except; exclusion when discharge is expected within 24 hours after admission. An added exclusion criterion; a second admission to a participating unit. |
Protocols | Daily visitor program, feeding assistance program, early mobilization program, therapeutic activities program. | No adaptation |
Volunteer shifts | Ranging from one to three times daily across protocols | Two times daily, one in the morning, one in the evening |
HELP staff | Program director: oversees and supervises the entire program within a hospital. | Project leader :oversees all aspects the project within a hospital. |
 | Elder Life Specialist: responsible for day-to-day operations of the program, patient screening and coordination of the volunteers. | Volunteer coordinator: screens volunteers, makes sure volunteers attend the training, coordinates and provides support volunteers. |
Nurse Practitioners: screen patients, complete instruction forms for volunteers. | ||
 | Elder Life Nurse Specialist: clinical assessment and intervention skills, develops and implements practical strategies to prevent cognitive and functional decline, provides education to nursing staff, liaison with other health care specialties. | Nurse Practitioners: complete the measurements on delirium, quality of life, and cognitive function. They are in close contact with the nurses and instruct them when necessary. |
 | Geriatrician: provides geriatric assessment and consultation upon request, education to physicians, liaison with hospital medical staff | No adaptations |
Staff nurses | ELS and ELNS are in contact with the staff nurses. | NP’s and volunteers are in contact with the staff nurses. The volunteers communicate with the staff nurses on patient level at the start and end of their shift. |
Outcomes | Advised: brief cognitive screening test, such as SPMSQ, Activities of Daily Living scores, vital status, length of hospital stay, discharge destination, use of home services, hospital costs. | Incidence, duration and severity of delirium, 6-CIT, Activities of Daily Living Scores, diagnosis, length of stay, care consumption after discharge, health care costs, quality of life. |