Healthcare Practice Improvement Assignment

Running head: HEALTHCARE PRACTICE IMPROVEMENT 1
Healthcare Practice Improvement Plan
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Institutional Affiliation
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HEALTHCARE PRACTICE IMPROVEMENT 2
Introduction
Delirium is a common yet often under-diagnosed or mismanaged disorder. As a result of
the aging population, the disorder is becoming more prevalent (Martins & Fernandes,
2012).Delirium is characterized by an inability to focus, change in cognition, reduced awareness
clarity, and distractibility(Martins & Fernandes, 2012).Delirium, which affects up to 50% of
elderly patients, can be clinically categorized as either hyperactive or hypoactive delirium. This
healthcare improvement plan will concentrate on hypoactive delirium.
Under hypoactive delirium, patients are usually withdrawn and quiet (Schuurmans,
Duursma& Shortridge, Baggett, 2001). Although there existstrategies to detect and diagnose
delirium, the disorder is oftenmisdiagnosed as dementia or not detected at all (Cole, 2005).
Studies by Fick, Agostini & Inouye (2002) emphasize the importance of recognizing and
consequently preventing delirium. Better knowledge and understanding of delirium among
professionals in the healthcare sector can lead to early detection,reduction of risk factors, and
better management in the acute phase (Saxena & Lowley, 2009). It is important to give attention
to the identification of delirium because more than half of the cases are potentially reversible.
Immediately delirium is detected, prompt management and intervention arecritical. Early
patient mobilization, removal of precipitating factors and environmental changes are all
warranted as soon a delirium is recognized. Once detected, delirium should be treated as an
emergency. It’s important to note that delirium causes a lot of distress to the patient, his or her
family, the healthcare staff and even the medical institution.The families delirium patients
describe the behavior and emotional manifestations as disturbing(Mailhot et al., 2014). Proper
care is necessary especially for patients with hypoactive dementia. The hospital and staff should
care for these patients so as to prevent the patient’s prolonged stay or more adverse effects.

HEALTHCARE PRACTICE IMPROVEMENT 3
Gaps
Research and treatment gaps exist in the early detection and management of hypoactive
delirium. Hypoactive delirium is characterized by a quiet and withdrawn behavior, and although
its presentation is more common than hyperactive delirium, the disorder is usually
overlooked(Hosker & Ward, 2017). Most of the patients with delirium are therefore often
undertreated or underdiagnosed. It is assumed that delirium is not a problem on its own but
merely a clinical symptom of other pathologies. Furthermore, although there is growing research
on hypoactive delirium, there is no conclusive evidence regarding symptom association and
presentation (Peritogiannis, Bolosi, Lixouriotis & Rizos, 2015 ). A lot of research focusing on
the primary care setting is needed. It is important to regularly assess all patients diagnosed with
delirium for signs of hypoactive delirium. Diagnosing delirium earlyon is necessary so as to
enable the patient and supporters to understand and accept the changes soas to plan for the
future.
Providing an enriching environment to patients with hypoactive delirium is
important.Delirium is usually treated through combining the treatment of presumed underlying
cause and by optimizing the patient's conditions. This treatment of deliriumshould, however,be
supplemented by initiating therapy and person-centered care(Hosker & Ward, 2017).To facilitate
their recovery, the patients need support from both their families and healthcareprofessionals.
Due to the symptoms of their disorder, patients with delirium are often stigmatized.
Another critical gap in relation to hypoactive delirium manifests in the educating the
medical staff. Professionals and care staff who deal with delirium related cases quite
oftenmisdiagnose delirium patients. Measures must be taken to sensitize the staff on ways to
detect the onset of delirium at the early stages. Patients with hypoactive delirium due to their

HEALTHCARE PRACTICE IMPROVEMENT 4
characteristic withdrawal are easily ignored. Without proper care mechanisms, these patients
may end up staying in hospital longer or even agitating their symptoms.
Person-centered care
In relation to delirium patients, person-centered care is an approach by a medical
institution that treats the staff, patients and their family as partners in developing and
administering care to meet their needs. It involves considering what the people desire and want.
Person-centered care is a term associated with high-quality care (Brooker, 2003). By utilizing a
person-centered approach, organizations can provide flexible, responsive and accessible services
that meet the preferences and needs of the community. With the demographic shift in Australia
and New Zealand whereby the number of old population is rapidly increasing, a person-centered
approach is important to provide support in managing delirium(Australian hospital statistics
2008-09, 2010).
A person-centered care approach enables patients and staff to make their own decisions
and control the services their lifestyle ( Richard, Coulter & Wicks, 2015). The medical care staff
will have a sense of responsibility for the people they take care. The organization will also be
well placed to provide responses that are culturally appropriate especially to patients with
delirium. A person-centered approach in treating patients with delirium will consequently help in
alleviating issues related to the identification and diagnosis of patients with delirium. The
personalized care with also contribute to reducing adverse effects of delirium that often result in
a prolonged stay in hospitals ( Brooker & Latham, 2015). This approach will especially be
significant to patients with hypoactive delirium. Such patients are often ignored because of their
‘undemanding’ nature. Since the approach is community-based involving friends and family, it
enables a wholesome health care system. Therefore, person-centered care can have significant