Quality contract 'prevention of postoperative delirium in the care of elderly patients' study protocol: a non-randomised, pre-post, monocentric, prospective trial.

Autor:	Yürek F; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Zimmermann JD; IT Consulting Company Specialised in Patient Data Management System (PDMS) and Hospital Information System (HIS), Auros GmbH, Berlin, Germany., Weidner E; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Hauß A; Business Division Nursing Directorate, Practice Development and Nursing Science, Charité Universitätsmedizin Berlin, Berlin, Germany., Dähnert E; Business Division Nursing Directorate, Practice Development and Nursing Science, Charité Universitätsmedizin Berlin, Berlin, Germany., Hadzidiakos D; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Kruppa J; Institute of Biometry and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Berlin, Germany., Kiselev J; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Sichinava N; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Retana Romero OA; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Hoff L; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Mörgeli R; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Junge L; Department of Anesthesiology and Intensive Care Medicine (CBF), Charité Universitätsmedizin Berlin, Berlin, Germany., Scholtz K; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Piper SK; Institute of Biometry and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Berlin, Germany., Grüner L; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Harborth AEM; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Eymold L; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Gülmez T; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Falk E; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Balzer F; Institute of Medical Informatics, Charité Universitätsmedizin Berlin, Berlin, Germany., Treskatsch S; Department of Anesthesiology and Intensive Care Medicine (CBF), Charité Universitätsmedizin Berlin, Berlin, Germany., Höft M; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany., Schmidt D; Department for Negotiations with Health Insurance Companies, Charité Universitätsmedizin Berlin, Berlin, Germany., Landgraf F; Outpatient Clinics, Charité Universitätsmedizin Berlin, Berlin, Germany., Marschall U; Statutory Health Insurance, BARMER, Wuppertal, Germany., Hölscher A; Statutory Health Insurance, BARMER, Wuppertal, Germany., Rafii M; Statutory Health Insurance, BARMER, Wuppertal, Germany., Spies C; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Charite Universitatsmedizin Berlin, Berlin, Germany claudia.spies@charite.de.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Mar 06; Vol. 13 (3), pp. e066709. Date of Electronic Publication: 2023 Mar 06.
DOI:	10.1136/bmjopen-2022-066709
Abstrakt:	Introduction: Postoperative delirium (POD) is seen in approximately 15% of elderly patients and is related to poorer outcomes. In 2017, the Federal Joint Committee (Gemeinsamer Bundesausschuss) introduced a 'quality contract' (QC) as a new instrument to improve healthcare in Germany. One of the four areas for improvement of in-patient care is the 'Prevention of POD in the care of elderly patients' (QC-POD), as a means to reduce the risk of developing POD and its complications.The Institute for Quality Assurance and Transparency in Health Care identified gaps in the in-patient care of elderly patients related to the prevention, screening and treatment of POD, as required by consensus-based and evidence-based delirium guidelines. This paper introduces the QC-POD protocol, which aims to implement these guidelines into the clinical routine. There is an urgent need for well-structured, standardised and interdisciplinary pathways that enable the reliable screening and treatment of POD. Along with effective preventive measures, these concepts have a considerable potential to improve the care of elderly patients. Methods and Analysis: The QC-POD study is a non-randomised, pre-post, monocentric, prospective trial with an interventional concept following a baseline control period. The QC-POD trial was initiated on 1 April 2020 between Charité-Universitätsmedizin Berlin and the German health insurance company BARMER and will end on 30 June 2023. Inclusion Criteria: patients 70 years of age or older that are scheduled for a surgical procedure requiring anaesthesia and insurance with the QC partner (BARMER). Exclusion criteria included patients with a language barrier, moribund patients and those unwilling or unable to provide informed consent. The QC-POD protocol provides perioperative intervention at least two times per day, with delirium screening and non-pharmacological preventive measures. Ethics and Dissemination: This protocol was approved by the ethics committee of the Charité-Universitätsmedizin, Berlin, Germany (EA1/054/20). The results will be published in a peer-reviewed scientific journal and presented at national and international conferences. Trial Registration Number: NCT04355195. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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