{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T23:39:28Z","timestamp":1782689968559,"version":"3.54.5"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T00:00:00Z","timestamp":1587340800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["RP-PG-0108-10037"],"award-info":[{"award-number":["RP-PG-0108-10037"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R24AG054259"],"award-info":[{"award-number":["R24AG054259"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>delirium is a frequent complication of hospital admission for older people and can be reduced by multicomponent interventions, but implementation and delivery of such interventions is challenging.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>to investigate fidelity to the prevention of delirium system of care within a multicentre, pragmatic, cluster randomised, controlled feasibility trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>five care of older people and three orthopaedic trauma wards in eight hospitals in England and Wales.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data collection<\/jats:title>\n                  <jats:p>research nurse observations of ward practice; case note reviews and examination of documentation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Assessment<\/jats:title>\n                  <jats:p>10 health care professionals with experience in older people\u2019s care assessed the fidelity to 21 essential implementation components within four domains: intervention installation (five items; maximum score\u2009=\u20095); intervention delivery (12 items; maximum score\u2009=\u200948); intervention coverage (three items; maximum score\u2009=\u200916); and duration of delivery (one item; maximum score\u2009=\u20091).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>the mean score (range) for each domain was: installation 4.5 (3.5\u20135); delivery 32.6 (range 27.3\u201338.3); coverage 7.9 (range 4.2\u201310.1); and duration 0.38 (0\u20131). Of the 10 delirium risk factors, infection, nutrition, hypoxia and pain were the most and cognitive impairment, sensory impairment and multiple medications the least consistently addressed. Overall fidelity to the intervention was assessed as high (\u226580%) in two wards, medium (51\u201379%) in five wards and low (\u226450%) in one ward.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>the trial was designed as a pragmatic evaluation, and the findings of medium intervention fidelity are likely to be generalisable to delirium prevention in routine care and provide an important context to interpret the trial outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaa042","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T20:16:13Z","timestamp":1582748173000},"page":"648-655","source":"Crossref","is-referenced-by-count":12,"title":["Investigation of ward fidelity to a multicomponent delirium prevention intervention during a multicentre, pragmatic, cluster randomised, controlled feasibility trial"],"prefix":"10.1093","volume":"49","author":[{"given":"Jane","family":"Smith","sequence":"first","affiliation":[{"name":"Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Green","sequence":"first","affiliation":[{"name":"Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najma","family":"Siddiqi","sequence":"first","affiliation":[{"name":"Hull York Medical School, University of York, York, UK"},{"name":"Bradford District Care NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon K","family":"Inouye","sequence":"first","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Harvard 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