A CLINICAL STUDY TO PILOT TEST THE ENVIRONMENTAL OPTIMIZATION INTERVENTIONS PROTOCOL (ELDERLY PATIENTS).
Contributors: Oregon Health Sciences University.
Published: 1991
Number of pages: 329
Subjects: Health Sciences, Nursing.; Gerontology.
Description: The purpose of this study, was to pilot test the environmental optimization interventions (EOI) and innovation strategies. The EOI were designed for use by staff nurses to reduce confusion with hospitalized, elderly patients. The EOI were evaluated in terms of their feasibility for implementation and acceptability to patients, families and friends, and nursing staff.

There were four categories of the environmental optimization intervention implemented by six staff nurses as part of their regular patient assignment. These categories were: focused assessment and meeting immediate personal needs; helping clients to organize their environment; providing meaningful sensory input; and maintaining independence in activities of daily living. The plan for implementation of the EOI protocol included an educational program; support activities to help the nurses transfer and maintain the study behaviors; and communication with the organization.

The EOI were tested with a convenience sample of 13, elderly patients representing different levels of confusion, admitted to an acute care, medical unit. A previous study provided data for the control condition. Repeated EOI measures of confusion, using the Neecham instrument and self-perception questions of confusion, were taken twice daily throughout the patient's hospitalization. The delivery of the EOI was monitored with the Observation Checklist for Selected EOI, EOI Reports, Nurse's Logs, and focus group meetings.

The small samples and differences in the admitting levels of confusion made comparisons between the groups difficult for examination of the effectiveness of the EOI. There was marked variability in the confusion trajectories for patients, particularly early in their hospital stay, which increases the importance of systematic, accurate, and periodic assessments of confusion by staff nurses. Although an atypical sample of nurses, the EOI nurses were successfully able to implement the EOI, with reported benefits for the patients and nurses. Frequent interruptions disrupted the development of the nurse-patient relationship.

The measures were reliable and had important clinical utility. The focus group was an effective mechanism for the ongoing evaluation of the EOI. Elderly patients and family members were interested in being involved in the evaluation of nursing care but different approaches are necessary.
Notes: Source: Dissertation Abstracts International, Volume: 53-02, Section: B, page: 0772.

Thesis (PH.D.)--OREGON HEALTH SCIENCES UNIVERSITY, 1991.

School code: 0368.