Modified Hospital Elder Life Program Reduces Post-Op Delirium and Length of Stay Interview with:
Cheryl Chia-Hui Chen, RN, DNSc

Vice Dean for Student Affairs
Professor of Nursing
National Taiwan University
Nurse Supervisor at National Taiwan University Hospital
Taipei, Taiwan What is the background for this study? What are the main findings?

Response: Older patients undergoing abdominal surgery often experience preventable delirium, which greatly influences their postoperative recovery and hospital length of stay. The modified Hospital Elder Life Program (mHELP) utilizes nurses to reduce postoperative delirium and LOS among older patients undergoing abdominal surgery for resection of malignant tumor. The mHELP consisted of 3 protocols: oral and nutritional assistance, early mobilization, and orienting communication, researchers say.

Researchers at the National Taiwan University Hospital randomly assigned 377 patients undergoing abdominal surgery for a malignant tumor to an intervention (n = 197) or usual care (n = 180).

Postoperative delirium occurred in 6.6 percent of mHELP participants vs 15.1 percent of control individuals (odds of delirium reduced by 56 percent). Intervention group participants received the mHELP for a median of 7 days, and they had a median LOS that was two days shorter (12 vs 14 days). What should readers take away from your report?

Response: “Keeping older people in the hospital well fed and hydrated, mobile, and oriented prevents postoperative delirium and reduces LOS. With just 30 minutes of nursing time per day per patient, development of postoperative delirium is delayed and reduced by 56%, and length of stay is shortened by 2 days for older patients undergoing abdominal surgery.” First author Dr. Cheryl Chia-Hui Chen from The National Taiwan University and National Taiwan University Hospital in Taipei told by email. Is there anything else you would like to add?

Response: An important message is that the mHELP provides a feasible, structured postoperative care protocols that target nutrition, mobilization, and cognition to prevent delirium and enhance recovery. It is an effective starting point to advance postoperative care.

No disclosure. Thank you for your contribution to the community.


Chen CC, Li H, Liang J, Lai I, Purnomo JDT, Yang Y, Lin B, Huang J, Yang C, Tien Y, Chen C, Lin M, Huang G, Inouye SK. Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal SurgeryA Cluster Randomized Clinical Trial. JAMA Surg. Published online May 24, 2017. doi:10.1001/jamasurg.2017.1083
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on May 24, 2017 by Marie Benz MD FAAD