This course is intended for the interdisciplinary members of the healthcare team in the hospital setting to improve knowledge of issues surrounding delirium in the elderly hospitalized patient. This 20-question module focuses on the evidence behind the epidemiology, risk factors, impact, and recognition of delirium in the geriatric patient. This course was created by Elaine Chang, and Kathryn Agarwal, MD, both from the Baylor College of Medicine. Listed below is information on obtaining continuing education credits for this course. This course is approved for CME, Nursing CE, Physical Therapy CUUs, Speech Therapy CUUs, Occupational Therapy CUUs, and Dietitians CPEs.
Photo of Robert Parker, MD, used by permission from Lisa Krantz and New York Times.
The funding for creation of this educational module is by the Texas Consortium Geriatric Education Center (TCGEC) at Baylor College of Medicine. Founded in 1985, the TCGEC is one of 48 such centers funded by the federal Health Resources and Services Administration.
The funding for the ongoing administration and continuing education credits for this educational module is supported by Funding Opportunity Number CMS- 1C1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.
We acknowledge the following individuals who reviewed and edited this module:
Catherine Currier-Buckingham, P.T. MBA
Elinor Hart, P.T.
Anita Major, M.D.
Judy Ragsdale, P.T.
James Rudolph, M.D.
Sarah Sheedy, MS CCC-SLP
Terry Throckmorton, PhD, RN
Delirium SpacedEd Education - CME /CE Credit Information
Studies have shown that in patients over age 70, there is a 14%-24% prevalence of delirium on hospital admission and a 6%-54% incidence of delirium in the hospital. However, delirium is missed frequently and is coded at very low levels.The low recognition factor vs. actual incidence is one the most significant problems in geriatrics.Clinicians do not recognize delirium as a severe problem, do not know how to diagnose it, and are unaware that it may be prevented with improved methods of care. By using an educational intervention that will include a commonly used diagnostic screening algorithm for delirium and delivering this intervention to all members of the health care team, we hope to significantly increase the rate of recognition of delirium.
Interactive Spaced Education [ISE] is a novel approach to online education in which small amounts of educational material are delivered and repeated over spaced intervals via interactive emails. Several recent randomized trials have demonstrated that this ISE methodology improves learning of medical knowledge and is extremely well accepted by learners.
Please click on this link to learn more about the observational research study that is occurring for participants taking this course.
The target audience for this activity is Physicians, Medical Trainees, Nurses, Nurse Practitioners, Physician Assistants, Physical Therapists, Occupational Therapists,Speech Therapists, Dietitians, and Social Workers
At the conclusion of this activity, the participants should be able to:
* Reference: Inouye SK, vanDyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: The Confusion Assessment Method. A new method for detection of delirium. Ann Intern Med. 1990; 113: 941-948. Confusion Assessment Method: Training Manual and Coding Guide, Copyright 2003, Hospital Elder Life Program, LLC. Not to be reproduced without permission.
The Interactive Spaced Education [ISE] Delirium Module 1: Recognition, Risk factors and Impact of Delirium in Hospitalized Elders program will consist of 20 multiple- choice questions on delirium in the geriatric patient in the hospital setting. The module will begin with two questions every other day in a single email from the website, www.qstream.com. This website will facilitate the delivery of questions and answers to the participant.
- If a question is answered incorrectly, the participant will receive the same question 6 days later.
- If a question is answered correctly, the participant will receive the same question 18 days later.
- If the participant answers the question correctly two times in a row, the question is then retired from the program and is no longer repeated.
- The participant will complete the program when all 20 questions are retired (each question is answered correctly twice in a row)
Given these parameters, it is estimated that the participant will complete the program in less than three months.
Participants may receive credit or contact hours ONLY by completing 80% of the questions in a module AND completing the end of module survey in LESS THAN FOUR MONTHS FROM TIME OF ENROLLMENT.
Accreditation and Credit Designation Statements
Physician CME Credits
Houston Methodist® is accredited by the Accreditation Council for Continuing Medical Education(ACCME) to provide continuing medical education for physicians.
Houston Methodist® designates this internet enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The estimated time to complete this education activity: 2.0 hours
Approval Term: January 2012-December 31,2013
Initial Review Date:August 30, 2011
Second Review Date: November 2013
Approval Term: January 1,2014-December 31,2015
Nursing CE Credit
Houston Methodist is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This module has been approved for 1.9 Contact Hours.
Physical Therapy CE Credit
This course has been approved by the Texas Board of Physical Therapy Examiners to meet continuing education requirements for P.T.s and P.T.A.s.
Contact Hours: 2.0
TPTA Approval ID#52327A
Speech Therapy CE Credit
Texas Speech-Language-Hearing Association (TSHA)
This continuing education activity was approved by the Texas Speech-Language-Hearing Association (TSHA) and can be applied toward the renewal o the Texas license in Speech-Language Pathology and/or Audiology as well as the Certificate of Clinical Competence from the America Speech-Language Hearing Association (ASH)
Contact Hours: 2.0
Course # 20120227441
Occupational Therapy CE Credit
This program has been approved for 2.0 CCU hours by the Texas Occupational Therapy Association.
Dietitians CPE Credit
This program has been approved for 3 CPEs by the CDR, the credentialing agency for the Academy of Nutrition.
Social Work CEU Credt
This workshop has been approved for (.19 ) CEUs (1.9 hours) for social workers by the Case Management and Social Work Department of Houston Methodist®.
Participants must attend the activity in its entirety and complete the evaluation tool.
How to Receive Credit
The following Spaced Education module consist of 20 multiple choice questions. Questions will be sent to you in small amounts from the website www.qstream.com. Once you answer a question correctly two times in a row, it will be completed. Participants may receive credit or contact hours ONLY by completing all 20 questions in a module AND completing the end of module survey in LESS THAN FOUR MONTHS FROM TIME OF ENROLLMENT. A certificate of participation will be available online following successful completion of the module and the post module survey.
Disclosure Policy and Procedure
Houston Methodist (HM) Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support,HM has implemented a mechanism requiring everyone in a position to control content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers, CME staff) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: 1) at the time of the activity or 12 months prior; and 2) of their spouses/partners.
Houston Methodist does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.
In addition, contributors have been requested to use generic names for products (drugs/devices), and to include various products within and across classes. If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the question about balance in the CME activity evaluation candidly.
Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with applicable law.
Houston Methodist requires that all faculty disclose any unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.
The following planning committee members disclosed having no financial relationships. There will not be mention of any off-label or unapproved uses.
Kathryn Agarwal, MD – Course Director
Assistant Professor - Baylor College of Medicine
George Taffet, MD- Course Co-Director
Professor - Baylor College of Medicine
Research Activities - Novartis
Chris Ralls, MBA – OCME Representative
CME Manager, Houston Methodist
Sponsored by Houston Methodist®.
This course is intended for the interdisciplinary members of the healthcare team in the hospital setting to improve knowledge of issues surrounding delirium in the elderly hospitalized patient. This 20-question module focuses on the evidence behind the epidemiology, risk factors, impact, and recognition of delirium in the geriatric patient.
Physicians, Medical Trainees, Nurses, Nurse Practitioners, Physician Assistants, Physical Therapists, Occupational Therapists, Speech Therapists, Dietitians, Social Workers, Case Managers
I completed the course on 11/17/13, have not yet received promised CE credit.
While the course material itself is educational, the testing construct and CE credit administration is poor. It promises CE credit upon completion, but ends up not delivering after the learner spends substantial time, energy, and effort completing the course. The learner, in fact, needs to seek out the course provider / developer in order to obtain CE credit.
I do not recommend this provider / educator or this website to colleagues.