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N/A N=737 Randomized Health Services Research

Determining the Preliminary Efficacy of the Emergency Department Delirium Screening and Detection Program

Delirium

Enrolled (actual)
737
Serious AEs
0.0%
Results posted
Mar 2026
Primary outcome: Primary: Proportion of Positive Delirium Screens Among Those With Delirium — 0; 10; 0; 1 Participants

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
ED Delirium Screening and Detection Program (ED-DDP) (Behavioral)
Age
Older Adult · 65+ yrs
Sex
All
Sponsor
Northwell Health
Primary completion
Oct 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Proportion of Positive Delirium Screens Among Those With Delirium
0; 10; 0; 1; 0; 0
SECONDARY
Proportion of Eligible Patients Who Receive Delirium Screening
23; 450; 6; 9; 67; 39
SECONDARY
Proportion of Eligible Patients Who Receive Safety Precautions
60; 140; 125; 131; 194; 67
SECONDARY
Proportion of Eligible Patients Who Receive Physical and Chemical Restraints for Behavioral Symptoms
13; 46; 34; 32; 88; 29

Summary

Delirium occurs in up to 20% of older adults presenting to the Emergency Department (ED) and is associated with poor outcomes. Failure to identify patients with ED delirium not only prevents initiation of mitigation strategies, but is also a barrier to advancing the field in terms of evaluating management and clinical outcomes. This project studies the potential of an ED Delirium Detection Program (ED-DDP), developed to address the need for consistent and accurate ED delirium detection. This research will have two objectives: * Aim 1 will conduct a pilot stepped wedge cluster randomized trial (SW-CRT) of the ED-DDP across 3 diverse EDs to determine preliminary efficacy of the detection training program, and * Aim 2 will use a mixed methods approach to assess RE-AIM implementation outcomes (Reach, Efficacy, Adoption, Implementation, and Maintenance) of the training program. Aim 1 will consist of a multicomponent 1-day delirium champion workshop where the training is delivered, real-time direct observation/training of champions via telehealth, practical training of nurses throughout each ED by champions, and patient chart review. In Aim 2, the investigators will assess implementation outcomes using training logs, tele-observation, interviews with champions and nurses, and electronic medical record screening. The overarching aim of this proposal is to determine the preliminary efficacy of the training program for improving ED delirium screening, detection, and management in older adults, while also evaluating implementation outcomes of the program for champions/nurses. The investigators will use findings from this study to inform a full-scale SW-CRT to evaluate the impact of the program on patient outcomes at Northwell Health. The long-term goal of this study is to implement and disseminate a comprehensive ED-DDP that will improve screening, detection, and management of ED delirium in older adults.

Eligibility Criteria

Inclusion Criteria

  • Presenting to a participating study site emergency department (ED) during control or intervention periods
  • Survival to ED discharge or to hospital admission

Exclusion Criteria

  • Presenting to a participating study site ED during ED-DDP implementation periods
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05638945). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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