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A Nurse‐Initiated Protocol for Interprofessional Management of Changed Behaviours in Hospital Patients With Dementia and/or Delirium: A Modified e‐Delphi Study
Frederick A. Graham, Christine Ossenberg, Amanda Jane Henderson. Journal of Advanced Nursing, 2025-01-02
Topic: Risk, prevention and care in population studies
Fifty-three experts participated (eight completed all rounds). Existing practices, opportunities and barriers were established in round one (n = 32), informing development of three multicomponent stages: (1) a bundle of bedside care comprising generic person-centred approaches, (2) a stepped-care workflow redirecting multidisciplinary teams to adopt an interprofessional approach to formulating individualised behavioural-care and (3) a one-page Behaviour Support Plan template. Content Validity Index scores for all items in round two (n = 29) were 0.89-0.96, meeting a priori consensus criteria, and negating the need for a third round. To improve outcomes for older hospital patients with changed behaviours, a multicomponent protocol for timely interprofessional formulation of point-of-care Behaviour Support Plans was established through expert panel consensus. IMPACT: Management of patient behaviours has resided almost solely with nursing, ignoring the potential inherent in ward-based multidisciplinary teams. A pragmatic procedure for initiating early interprofessional support to nurses' management of behaviours may potentially improve care, safety and outcomes for patients and staff alike. Ready for feasibility testing in hospitals, the protocol capitalises on existing multidisciplinary resources. REPORTING
Key findings
- Fifty-three experts participated (eight completed all rounds).
- Existing practices, opportunities and barriers were established in round one (n = 32), informing development of three multicomponent stages: (1) a bundle of bedside care comprising generic person-centred approaches, (2) a stepped-care workflow redirecting multidisciplinary teams to adopt an interprofessional approach to formulating individualised behavioural-care and (3) a one-page Behaviour Support Plan template.
- Content Validity Index scores for all items in round two (n = 29) were 0.89-0.96, meeting a priori consensus criteria, and negating the need for a third round.
- To improve outcomes for older hospital patients with changed behaviours, a multicomponent protocol for timely interprofessional formulation of point-of-care Behaviour Support Plans was established through expert panel consensus.
- IMPACT: Management of patient behaviours has resided almost solely with nursing, ignoring the potential inherent in ward-based multidisciplinary teams.
Why it matters
This modified e-Delphi study established a multicomponent protocol for interprofessional formulation of point-of-care Behaviour Support Plans for hospital patients with dementia and/or delirium. The protocol is ready for feasibility testing in hospitals but has not yet been tested for effectiveness.
Study details
- Participants32
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Advanced Nursing) |
| Journal's citation record | 3 / 4 | Journal of Advanced Nursing: journal h-index 262 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 1 / 4 | 32 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 5 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 6.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Amanda Jane Henderson: h-index 44 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | The University of Queensland: institution h-index 1,516 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39744863) |
| Free to read | 2 / 2 | Free to read |
| Total | 47 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1111/jan.16721
- PubMed: 39744863
- Original source →
- Free full text: Griffith Research Online →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Graham, F. A., Ossenberg, C., & Henderson, A. J. (2025). A Nurse‐Initiated Protocol for Interprofessional Management of Changed Behaviours in Hospital Patients With Dementia and/or Delirium: A Modified e‐Delphi Study. Journal of Advanced Nursing. https://doi.org/10.1111/jan.16721
Vancouver
Graham FA, Ossenberg C, Henderson AJ. A Nurse‐Initiated Protocol for Interprofessional Management of Changed Behaviours in Hospital Patients With Dementia and/or Delirium: A Modified e‐Delphi Study. Journal of Advanced Nursing. 2025. doi:10.1111/jan.16721. PMID: 39744863.
BibTeX
@article{graham2025-39744863,
author = {Graham, Frederick A. and Ossenberg, Christine and Henderson, Amanda Jane},
title = {{A Nurse‐Initiated Protocol for Interprofessional Management of Changed Behaviours in Hospital Patients With Dementia and/or Delirium: A Modified e‐Delphi Study}},
journal = {Journal of Advanced Nursing},
year = {2025},
doi = {10.1111/jan.16721},
pmid = {39744863},
url = {https://doi.org/10.1111/jan.16721}
}
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