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Table 1 Comparison US and Dutch HELP

From: Design and methods of the Hospital Elder Life Program (HELP), a multicomponent targeted intervention to prevent delirium in hospitalized older patients: efficacy and cost-effectiveness in Dutch health care

  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.
  1. SPMSQ = Short Portable Mental Status Questionnaire [32].