The overall goal is to reduce the incidence and burden of delirium, as measured by the delirium burden index (DBI) among hospitalized older adults (≥70 years), by modifying the inpatient environment to decrease its sleep antagonism. The investigators propose to implement a multi-modal sleep hygiene (MMSH) bundle, an enhancement of a previously reported sleep-focused intervention which had 88 - 100% compliance for intervention components, and reduced ICU delirium by 50%.
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Incidence (cumulative or proportion) of hospital acquired delirium (HAD) among patients who did not have delirium present on admission (D-POA)
Timeframe: From the date of admission to the date of discharge or death, whichever comes first, outcome will be assessed at every 12 hours (twice in a 24 hour time period), up to 5 years
Delirium Burden Index (DBI) among patients with either delirium present on admission or those who develop HAD
Timeframe: From the date of admission to the date of discharge or death, whichever comes first, outcome will be assessed at every 12 hours (twice in a 24 hour time period), up to 5 years
Adherence to MMSH bundle components: Nighttime and Daytime
Timeframe: Starting from the date of randomization till the date of termination of the study assessments will be made twice weekly for each unit, up to 5 years
Factors facilitating or impeding implementation of MMSH bundle
Timeframe: From the date of randomization assessments made up to 5 years