A knowledge transfer study of the utility of the nova scotia seniors' mental health network in implementing seniors' mental health national guidelines.

BACKGROUND: The Canadian Coalition for Seniors' Mental Health (CCSMH) developed national best-practice guidelines in seniors' mental health. Promoting adoption of new guidelines is challenging, as paper dissemination alone has limited impact on practice change. PURPOSE: We hypothesized that the existing knowledge transfer (KT) mechanisms of the Nova Scotia Seniors' Mental Health Network would prove useful in transferring the CCSMH best-practice guidelines. METHODS: In this observational KT study, CCSMH best-practice guidelines were delivered through two interactive, case-based teaching modules on Depression & Suicide, and Delirium via a provincial tele-education program and local face-to-face sessions. Usefulness of KT was measured using self-report evaluations of material quality and learning. Evaluation results from the two session topics and from tele-education versus face-to-face sessions were compared. RESULTS: Sessions were well attended (N = 347), with a high evaluation return rate (287, 83%). Most participants reported enhanced knowledge in seniors' mental health and intended to apply knowledge to practice. Ratings did not differ significantly between KT session topics or modes of delivery. CONCLUSIONS: The KT mechanisms of a provincial seniors' mental health network facilitated knowledge acquisition and the intention of using national guidelines on seniors' mental health among Nova Scotian clinicians. Key elements of accelerating KT used in this initiative are discussed.

Developing guidelines on the assessment and treatment of delirium in older adults at the end of life.

BACKGROUND AND PURPOSE: Delirium at the end of life is common and can have serious consequences on an older person's quality of life and death. In spite of the importance of detecting, diagnosing, and managing delirium at the end of life, comprehensive clinical practice guidelines (CPG) are lacking. Our objective was to develop CPG for the assessment and treatment of delirium that would be applicable to seniors receiving end-of-life care in diverse settings. METHODS: Using as a starting point the 2006 Canadian Coalition for Seniors' Mental Health CPG on the assessment and treatment of delirium, a team of palliative care researchers and clinicians partnered with members of the original guideline development group to adapt the guidelines for an end-of-life care context. This process was supported by an extensive literature review. The final guidelines were reviewed by external experts. RESULTS: Comprehensive CPG on the assessment and treatment of delirium in older adults at the end of life were developed and can be downloaded from http://www.ccsmh.ca. CONCLUSIONS: Further research is needed on the implementation and evaluation of these adapted delirium guidelines for older patients receiving end-of-life care in various palliative care settings.