{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:26:59Z","timestamp":1762183619311,"version":"build-2065373602"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["READI\/R01AG030618","K24AGO35075"],"award-info":[{"award-number":["READI\/R01AG030618","K24AGO35075"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systematic screening can improve delirium identification among hospitalized older adults. Prior studies have shown clinicians and health system leaders may believe they do not have the time and resources for assessment. We conducted a comparative salary\u2010related cost analysis of an adaptive delirium identification protocol directed by an iPad app.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We recruited 527 older adult medicine patients from an urban academic medical center (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0269) and a rural community hospital (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0258). Physicians and nurses completed the two\u2010step Ultra\u2010brief Confusion Assessment Method (UB\u2010CAM) protocol (with or without a skip pattern), while certified nursing assistants completed only the UB\u20102 ultra\u2010brief screen. The sample included 527 patients (average age 80, 57% women, 35% with dementia). Time required to administer the protocol was collected automatically by the iPad app. Salary\u2010related costs of screening were determined by multiplying the time required by the hourly wage for the three disciplines, as obtained from national and regional published healthcare salary cost data. Cost estimates for entire hospital implementation were also calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants were screened on 924 hospital days by 399 clinicians (53 physicians, 236 nurses, 110 CNAs). For the UB\u20102, CNAs cost per screen was lower than the other clinician types ($0.37 per screen vs. $0.73 for nurses and $2.39 for hospitalists). For the UB\u2010CAM with skip (UB\u2010CAM), costs per protocol were $1.10 for nurses vs. $3.61 for physicians. The annual salary\u2013related costs of hospital\u2010wide implementation of a nurse\u2010based UB\u2010CAM protocol in a medium\u2010sized (300\u2010bed) hospital was $63,015 plus $4356 for initial and annual training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CNAs and nurses had the lowest salary\u2010associated costs for app\u2010directed CAM\u2010based delirium screening and identification, respectively. Salary\u2010related annual hospital costs for the most efficient protocols in a medium\u2010sized hospital were less than the annual cost of hiring 1 FTE of the discipline performing the protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17789","type":"journal-article","created":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T07:24:54Z","timestamp":1650439494000},"page":"2371-2378","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparative\n                    <scp>salary\u2010related<\/scp>\n                    costs of a brief app\u2010directed delirium identification protocol by hospitalists, nurses, and nursing assistants"],"prefix":"10.1111","volume":"70","author":[{"given":"Douglas L.","family":"Leslie","sequence":"first","affiliation":[{"name":"College of Medicine The Pennsylvania State University  Hershey Pennsylvania 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K.","family":"Inouye","sequence":"additional","affiliation":[{"name":"Divisions of General Medicine and Gerontology Harvard Medical School  Boston Massachusetts USA"},{"name":"Aging Brain Center, Marcus Institute for Aging Research, Hebrew SeniorLife  Boston Massachusetts USA"},{"name":"Division of Gerontology, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoojin","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of General Medicine, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long H.","family":"Ngo","sequence":"additional","affiliation":[{"name":"Division of General Medicine, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Divisions of General Medicine and Gerontology Harvard Medical School  Boston 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Internal Medicine and Geriatrics Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward R.","family":"Marcantonio","sequence":"additional","affiliation":[{"name":"Division of General Medicine, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Divisions of General Medicine and Gerontology Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gerontology, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts 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