PT - JOURNAL ARTICLE AU - Jackson, Gillian AU - Pearson, Mark AU - Jackson, Catriona AU - Boland, Jason AU - Featherstone, Imogen AU - Huang, Chao AU - Ogden, Margaret AU - Sartain, Kathryn AU - Siddiqi, Najma AU - Twiddy, Maureen AU - Johnson, Miriam TI - O-13 Improving the Detection, assessment, management and prevention of delirium in hospices: The DAMPen-Delirium feasibility study AID - 10.1136/spcare-2022-HUNC.13 DP - 2022 Nov 01 TA - BMJ Supportive & Palliative Care PG - A6--A6 VI - 12 IP - Suppl 3 4099 - http://spcare.bmj.com/content/12/Suppl_3/A6.1.short 4100 - http://spcare.bmj.com/content/12/Suppl_3/A6.1.full SO - BMJ Support Palliat Care2022 Nov 01; 12 AB - Background Delirium causes severe distress for patients, families, and staff. One-third of people admitted to adult palliative care units have delirium and two-thirds develop delirium during their stay (Watt, Momoli, Ansari, et al., 2019. Palliat Med. 33:865), yet implementation of clinical guidelines is poor (NICE. Delirium: prevention, diagnosis and management - Clinical Guideline 103, 2010). Strategies are needed to address the gap between knowledge and action (Featherstone, Hosie, Siddiqi, et al., 2021. Palliat Med. 35: 988).Aim To assess the feasibility of timely and reliable clinical record data collection in hospices with different socio-economic profiles and record-keeping methods.Methods Phase one of the ongoing feasibility study collects clinical record data (demographic; evidence of delirium; [Inouye, Leo-Summers, Zhang, et al., 2005. J Am Geriatr Soc. 53: 312] guideline-adherent delirium care) from 50 consecutive in-patient admissions at four hospices. Data collection will be repeated following implementation of the co-designed Creating Learning Environments for Compassionate Care-Palliative (CLECC-Pal) intervention to support delirium guideline-adherence. The variation around baseline number of patient days with delirium will be calculated to inform the sample size needed for a future multi-site effectiveness study.Results To date, 100 clinical records have been reviewed from two hospices. In-patient characteristics differ considerably in age (mean 89 vs. 70 years), deprivation quintile (80% vs. 38% in least-deprived) and diagnosis (90% vs. 72% cancer). Overall, two-thirds of patients had a delirium episode during admission, for whom >75% of their in-patient days were delirium days. A delirium diagnosis was documented by the clinical team in <10% of cases. Guideline-adherent delirium risk assessment and screening was not documented in clinical records.Conclusion Our ongoing study is demonstrating: i) the feasibility of systematically and reliably collecting clinical record data about delirium occurrence and management; ii) the gap between need for delirium care and action (low guideline-adherence). Our emerging findings demonstrate the imperative for, and feasibility of, conducting a multi-site effectiveness study of the CLECC-Pal strategy for improving guideline-adherence in delirium care. For more on this study, see also Poster P-104: Improving the Detection, Assessment, Management and Prevention of Delirium in Hospices: The DAMPen-Delirium co-design process, by Mark Pearson et al.