Proven Advancements in Countering the Effects of Geriatric Delirium

Program Establishing the Foundation for New Protocol of Care

In 2011, Hackensack University Medical Center earned The Joint Commission’s (JC) Disease Specific Certification (DSC) in Geriatric Delirium, the first such certification awarded in the country. Since then, Hackensack has been re-certified four times for having a structured program to identify, prevent and manage this serious syndrome, which can often lead to poor hospital outcomes for elderly patients.

Part of the certification process is to identify quality metrics and report them on a monthly basis to the JC and a Geriatric Quality Council. The current quality metrics include: medication education, hearing impairment intervention for hard of hearing patients, monitoring patient satisfaction, and identifying delirium using the Confusion Assessment Method on all adult inpatients.

As a DSC, the Division of Geriatrics at Hackensack has been able to implement a Confusion Assessment Method screening on all hospitalized patients who are 65 years and older, and as a result, we have increased compliance to more than 90% (since receiving DSC in 2011).

Additionally, we’ve seen important advancements in three key areas:

  1. Hearing impairment: By assessing for hearing impairment, a key risk factor for delirium, we’ve been able to provide intervention for 80% of our hospitalized—compared to only 30% before receiving the DSC.
  2. Early patient mobilization: Deployed a “nurse-driven mobility protocol” to get more than 95% of patients out of bed within 24 hours of admission to help combat physical deconditioning.
  3. Monitoring of psychotropic medication: Because this type of medication can lead to increased incidence of delirium, we’ve been able to decrease our high-risk medication use to 5.6%, which is way below the national average.
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