Improving the Interfacility Transport Experience Implementation of a Mobile Delirium/Hospice Box
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Abstract
As the U.S. populace ages, interfacility transport teams face unique challenges in addressing the needs of two rapidly growing patient populations. Both elderly individuals at risk for delirium and those transitioning to comfort-based care, such as hospice are increasingly utilizing interfacility transport resources as the interact with the medical system. Current care modalities for patients are primarily centered on medical stability during transport and do not adequately address aspects such as patient comfort or alignment with goals when a patient is on hospice or at risk for delirum.
To address these challenges, a delirium/hospice care box was designed and implemented as part of a high-volume critical care transport program. This box was created to enhance the patient experience by targeting cognitive engagement, comfort, and sensory support. Items included in the box for cognitive engagement consisted of a Bluetooth speaker intended to play music of the patient’s choice, fidget toys, sound amplifiers for those who are hard of hearing, and realistic baby dolls for patients with advanced dementia. Comfort and sensory support items included a medical-grade, wipeable weighted blanket, sunglasses, oral care products, essential oils, a clip-on fan, and other items. These were selected based on prior research demonstrating their benefits for this population.
The box was funded by a hospital grant and implemented within a busy interfacility transport team at a quaternary care academic center. The goals of the box included enhancing the transport experience, potentially reducing delirium, and aligning the care provided during interfacility transports with the goals of a unique but growing patient population.
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