Prevention of Unbearable Situations and Harms Protocol: A Quality Improvement Initiative in Neurological Delirium.

ABSTRACT:

Background and purpose

Hyperactive delirium in neurological wards frequently results in patient harm, falls, device removal, and caregiver injuries, alongside significant staff burnout. To address inconsistent management practices, we developed the Prevention of Unbearable Situations and Harms (PUSH) protocol, a structured multidisciplinary approach to proactively manage hyperactive delirium. This study evaluated the effectiveness of the PUSH protocol in reducing delirium-related adverse events (primary outcome), and improving clinical workflow, staff burnout, and satisfaction (secondary outcomes).

Methods

We conducted a pre-post study in three phases: pre-implementation (November 2021-May 2022), pilot testing (June-August 2022), and post-implementation (September 2022-March

SUBMITTER: Kim MS 

PROVIDER: S-EPMC12569426 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature