• Andrea M Yevchak, Donna M Fick, Jane McDowell, Todd Monroe, Kanah May, Lori Grove, Ann M Kolanowski, Jennifer L Waller, and Sharon K Inouye.
• Pennsylvania State University School of Nursing, University Park, USA.
• Clin Nurs Res. 2014 Apr 1; 23 (2): 201-15.

AbstractDelirium occurs in more than half of hospitalized older adults with dementia, substantially worsening outcomes. The use of multiple strategies and a local opinion leader, unit champion, has cumulative and lasting effects compared with single-strategy interventions. The purpose of this article is to describe the early barriers and facilitators to rounding with unit champions in a cluster randomized clinical trial in Year 2 of a 5-year trial (5R01NR011042-02). This is a mixed-method study nested within an ongoing multisite cluster-randomized, controlled clinical trial. Descriptive and comparative statistics were collected on N = 192 nursing rounds. Qualitative data were thematically analyzed. On average, rounds lasted 25.54 min (SD = 13.18) and were conducted with the unit champion 64% of the time. This is one of the first studies to systematically address quantitative and qualitative barriers and facilitators to nurse-led delirium rounds, demonstrating the gradual adoption of an intervention in diverse clinical settings.

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