Evidence map›Paper›PMID 35441698›Full record

ArticleJournal of the American Geriatrics Society2022

Comparative salary-related costs of a brief app-directed delirium identification protocol by hospitalists, nurses, and nursing assistants.

Douglas L Leslie, Donna M Fick, Amber Moore, Sharon K Inouye, Yoojin Jung, Long H Ngo, Marie Boltz, Erica Husser, Priyanka Shrestha, Malaz Boustani and 1 more

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Douglas L LeslieCollege of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.
Donna M FickCollege of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA.ORCID 0000-0002-6777-1913
Amber MooreDivision of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Sharon K InouyeDivisions of General Medicine and Gerontology, Harvard Medical School, Boston, Massachusetts, USA.
Yoojin JungDivision of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Long H NgoDivision of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Marie BoltzThe Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA.
Erica HusserThe Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA.
Priyanka ShresthaThe Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA.ORCID 0000-0003-3817-747X
Malaz BoustaniDivision of Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Edward R MarcantonioDivision of General Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Beth Israel Deaconess Medical Center · USPennsylvania State University · USIndiana University School of Medicine

Funding

READI-SET-GO: Researching Efficient Approaches to Delirium Identification - Sustaining Effective Translation to create Gero-friendly OrganizationsR01AG030618 · NIA · PENNSYLVANIA STATE UNIVERSITY, THE · PI DONNA Marie FICK, EDWARD R MARCANTONIO · 2008 to 2026
$7.9M
Early Nurse Detection of Delirium Superimposed on Dementia (END DSD)R01NR011042 · NINR · PENNSYLVANIA STATE UNIVERSITY, THE · PI FICK, DONNA MARIE · 2010 to 2014
$2.6M
Mid-Career Mentoring Award for Patient-Oriented Research in AgingK24AG035075 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MARCANTONIO, EDWARD R · 2010 to 2021
$1.9M
NIA NIH HHS K24 AG035075NIA NIH HHS R01 AG030618NINR NIH HHS R01 NR011042
6 · The paper itself

Abstract

backgroundSystematic 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-related cost analysis of an adaptive delirium identification protocol directed by an iPad app.

methodsWe recruited 527 older adult medicine patients from an urban academic medical center (n = 269) and a rural community hospital (n = 258). Physicians and nurses completed the two-step Ultra-brief Confusion Assessment Method (UB-CAM) protocol (with or without a skip pattern), while certified nursing assistants completed only the UB-2 ultra-brief 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-related 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.

resultsParticipants were screened on 924 hospital days by 399 clinicians (53 physicians, 236 nurses, 110 CNAs). For the UB-2, 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-CAM with skip (UB-CAM), costs per protocol were $1.10 for nurses vs. $3.61 for physicians. The annual salary-related costs of hospital-wide implementation of a nurse-based UB-CAM protocol in a medium-sized (300-bed) hospital was $63,015 plus $4356 for initial and annual training.

conclusionsCNAs and nurses had the lowest salary-associated costs for app-directed CAM-based delirium screening and identification, respectively. Salary-related annual hospital costs for the most efficient protocols in a medium-sized hospital were less than the annual cost of hiring 1 FTE of the discipline performing the protocols.

Indexed as

DeliriumHospitalistsMobile ApplicationsNursing AssistantsAgedAged, 80 and overFemaleHumansMaleSalaries and Fringe Benefitscost-analysisdeliriumimplementationscreening

Identifiers

PMID35441698
PMCPMC9378349
OpenAlexW4224267153

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.