A greater number of room transfers per patient days was strongly associated with new-onset delirium within the first week of hospitalization among elderly medical patients, according to the results of a study published in the June 25, 2015, issue of BMC Geriatrics. The study, which evaluated 994 patients age 70 years or older who were admitted to the internal medicine or geriatric medicine services at a Canadian tertiary care medical center between October 2009 and September 2010, concludes that room transfers are a potentially modifiable risk factor for reducing delirium incidence among hospitalized elderly patients. The data did not indicate an association between bed spacing and delirium incidence or between being in a single-person room and delirium incidence—findings the researchers suggest may be because bed spacing and room type do not contribute to patient disorientation. The researchers propose that the delirium-provoking effects of room transfers may be related to changes in the environments and in the staff caring for patients. They note that in recent studies, prevention strategies primarily focused on patient reorientation helped reduce the incidence of delirium, and they recommend considering such strategies for patients who undergo frequent room transfers.

HRC Recommends: It is well known that delirium is linked to cognitive and functional decline, as well as increased risk of morbidity and mortality. Hospital risk managers and patient safety officers may wish to track the number of room transfers that occur per patient-day and consider what strategic changes in the environment of care and staffing might be implemented to reduce the risk of delirium related to room transfers. Facilities should ensure that staff are trained on how to identify delirium and signs or symptoms of mental health needs, as well as how to identify any potential underlying causes.