Evaluation of a multidimensional occupational therapy environmental checklist for people experiencing delirium during hospital admission

Background Delirium, an acute medical emergency, significantly impacts older adults, increasing morbidity, mortality, and healthcare costs (estimated at $806–$24,509 per patient in Australia). Environmental modifications in hospital wards are underexplored despite their potential to mitigate delirium’s effects. This study evaluated a multidimensional occupational therapy environmental checklist’s impact on functional and service outcomes for hospitalised delirium patients compared to standard care. Methods A quasi-experimental design was employed, collecting pre- and post-intervention data from 100 electronic medical records (50 control, 50 intervention) on the Geriatric Evaluation and Management ward in Melbourne, Australia. The Checklist, implemented by occupational therapists and allied health assistants, targeted orientation, object accessibility, daily routines, and safety. Outcomes included length of stay, adverse events (e.g., falls, pressure injuries), and Functional Independence Measure (FIM) scores. Descriptive statistics, t-tests, and chi-square tests were conducted using SPSS Statistics 28 (p<0.05). Results The intervention group showed a 27.3% reduction in total adverse events (control: n=37; intervention: n=27) and significantly higher FIM scores at discharge (motor: t=-2.38, p=0.02; cognitive: t=-2.62, p=0.01; total: t=-3.24, p=0.00). However, length of stay (control: M=28.2 days; intervention: M=29.36 days; t=-0.20, p=0.84) and adverse event rates (X2=1.48, p=0.22) did not differ significantly. The intervention group had a higher falls admission rate (36.0% vs. 2.0%; X2=20.38, p=0.00). Conclusion The Checklist enhances functional recovery in older adults with delirium, reducing adverse events. Larger, multi-site studies are needed to confirm efficacy and generalizability, supporting occupational therapy’s role in delirium management.