Delirium prevention and management interventions codesigned with people with lived experience.
Gideon Johnson, a Senior Teaching Fellow in the Faculty of Nursing, Midwifery and Palliative Care, has been working on a family-led intervention to prevent critical illness brain dysfunction, also known as delirium.
The intervention, called Family Member's Voice Reorientation Intervention (FAMVR) uses familiar voices to provide ongoing orientation to critically ill patients in order to prevent or manage delirium.
Delirium is a common consequence of intensive care admission, and there is limited evidence to support family-led interventions to prevent or minimise delirium in intensive care. Up to this point, people with lived experience of intensive care have seldom been involved in codesigning delirium prevention and management interventions, despite the identified benefit of their involvement in delirium care.
The development of FAMVR was done with collaboration from people with lived experience of the ICU, as patients, family members, nursing and medical staff.
Through consultations and focus groups, researchers created drafts of scripted messages that family members could record for patients in the ICU, that would be played to those experiencing delirium to orient patients and reduce their experience of delirium.
Two research papers have been published from the first phase of Gideon's two-phase study, entitled 'The Development, Implementation and Evaluation of a Novel Intervention for Delirium Prevention and Management in Adult Intensive Care Unit: A Mixed Methods Study'. This study formed a part of his PhD.
One paper focuses on the study's unique methodology, and another on the findings.
This study addresses a critical gap in intensive care practice by highlighting the necessity of co-designed interventions tailored to the needs of both patients and their families. The use of the Double Diamond model ensured a structured and iterative process, allowing us to create a more human-centred approach to delirium prevention and management. By engaging end-users from the outset, we've developed a digital intervention that not only enhances care but also empowers families as active participants in the healing process. I hope this research paves the way for more collaborative, co-designed solutions in critical care settings, improving outcomes for critically ill patients.
Gideon Johnson, Senior Teaching Fellow
Phase two of the study has already been completed, with the paper under review and a publication expected soon. These Phase one findings are now contributing to a broader initiative: a Critical Illness Brain Dysfunction Survivorship Programme that Gideon Johnson is establishing in the UK, modeled after the CIBS programme in the US.
This programme will further the impact of the intervention, addressing long-term cognitive issues following critical illness.
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Senior Teaching Fellow
