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Delirium education

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https://www.readbyqxmd.com/read/28436344/inattention-tests-for-delirium
#1
Paul Regal
Voyer and colleagues (2016) report an interesting and important comparison of ten attention/concentration tests for DSM-5 delirium. I have a number of questions and comments as follows: (1) What training did the research assistants have? DSM-5 diagnosis is generally regarded as a decision by medical specialists. When the person has prior dementia, identifying delirium is a high-level medical skill. Behavioral and psychological symptoms of dementia can closely mimic delirium unless the examiner focuses on behavioral triggers and the speed of cognitive decline...
April 24, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28434804/nurses-knowledge-and-perception-of-delirium-screening-and-assessment-in-the-intensive-care-unit-long-term-effectiveness-of-an-education-based-knowledge-translation-intervention
#2
Sharon L Hickin, Sandra White, Jennifer Knopp-Sihota
OBJECTIVES: To determine the impact of education on nurses' knowledge of delirium, knowledge and perception of a validated screening tool, and delirium screening in the ICU. METHODS: A quasi-experimental single group pretest-post-test design. SETTING: A 16 bed ICU in a Canadian urban tertiary care centre. MAIN OUTCOME MEASURES: Nursing knowledge and perception were measured at baseline, 3-month and 18-month periods. Delirium screening was then assessed over 24-months...
April 20, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28410275/implementation-of-an-icu-bundle-an-interprofessional-quality-improvement-project-to-enhance-delirium-management-and-monitor-delirium-prevalence-in-a-single-picu
#3
Shari Simone, Sarah Edwards, Allison Lardieri, L Kyle Walker, Ana Lia Graciano, Omayma A Kishk, Jason W Custer
OBJECTIVES: To examine the impact of an ICU bundle on delirium screening and prevalence and describe characteristics of delirium cases. DESIGN: Quality improvement project with prospective observational analysis. SETTING: Nineteen-bed PICU in an urban academic medical center. PATIENTS: All consecutive patients admitted from December 1, 2013, to September 30, 2015. INTERVENTIONS: A multidisciplinary team implemented an ICU bundle consisting of three clinical protocols: delirium, sedation, and early mobilization using the Plan-Do-Study-Act cycles as part of a quality improvement project...
April 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28410038/critical-care-nurses-knowledge-and-practice-of-delirium-assessment
#4
Gabby Rowley-Conwy
AIMS: The aim of this study was to examine perceived barriers to assessment of delirium for critical care nurses, and the impact of education on their knowledge and practice. BACKGROUND: Delirium is a significant problem in critical care, leading to increased morbidity and mortality. Many authors have found variations in assessment by critical care nurses, but there has been limited analysis of the reasons for this. Education on the topic improves knowledge and practice, but the best approach has not been examined...
April 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28384462/can-a-10-minute-questionnaire-identify-significant-psychological-issues-in-patients-with-temporomandibular-joint-disease
#5
Shang-Lun Lin, Shang-Liang Wu, Hsien-Te Huang, For-Wey Lung, Tzong-Cherng Chi, Jung-Wu Yang
PURPOSES: For patients with disc displacement disorders (DDDs), psychiatric illness increases the risk of worsening postsurgical pain, postoperative delirium, postoperative incomplete recovery, and worse postoperative life quality. This study provides a fast and practical protocol to evaluate psychological conditions of patients with DDDs of the temporomandibular joint (TMJ) in clinical care. MATERIALS AND METHODS: The populations under investigation in this cross-sectional study included patients with DDD who received treatment from October 2012 through June 2016...
March 14, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28375046/delirium-assessed-by-memorial-delirium-assessment-scale-in-advanced-cancer-patients-admitted-to-an-acute-palliative-supportive-care-unit
#6
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Andrea Cortegiani, Alessandra Casuccio
BACKGROUND: Delirium is often unrecognized in cancer patients. The aim of this study was to investigate the prevalence of delirium assessed by Memorial Delirium Assessment Scale (MDAS), and possible associated factors associated on admission to an acute palliative/supportive care unit (ASPCU). The secondary outcome was to assess changes in MDAS and symptom burden at time of discharge. METHODS: A consecutive sample of advanced cancer patients who were admitted to an ASPCU was prospectively assessed for a period of 10 months...
April 4, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28326870/misidentification-of-mental-health-symptoms-in-presence-of-organic-diseases-and-delirium-during-psychiatric-liaison-consulting
#7
Victor Henrique Oyamada Otani, Thaís Zélia Dos Santos Otani, Andrea Freirias, Elie Leal de Barros Calfat, Patricia Satiko Aoki, Quirino Cordeiro, Richard A A Kanaan, Sean Cross, Susan Liersch-Sumskis, Ricardo Riyoiti Uchida
OBJECTIVE: To identify predictors of misidentification of organic mental disorders and delirium in patients undergoing psychiatric liaison consultation. METHODS: Data were collected at Santa Casa de São Paulo between July of 2009 and March of 2013. We included in our analysis all inpatients for whom the requesting service judged that a psychiatric consultation was required for a possible mental health condition. Outcomes of interest were the instances of misidentification where a condition was initially deemed to be of a psychiatric nature, whereas the final diagnosis by the liaison psychiatric team was of an organic disease or delirium...
March 22, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28320171/stroke-severity-predicts-poststroke-delirium-and-its-association-with-dementia-longitudinal-observation-from-a-low-income-setting
#8
Akin Ojagbemi, Mayowa Owolabi, Toyin Bello, Olusegun Baiyewu
OBJECTIVE: The effect of delirium on stroke outcome has not been quantified in sub-Saharan Africa. We investigated the prevalence of delirium occurring within one week of stroke in Nigerian survivors and its association with dementia and mortality at 3months. METHODS: Delirium was ascertained after repeated assessments within one week of stroke using the Confusion Assessment Method. Demographic and clinical characteristics, stroke severity, current and pre-morbid cognitive functioning were also assessed...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28288622/cogchamps-a-model-of-implementing-evidence-based-care-in-hospitals-study-protocol
#9
Catherine Travers, Frederick Graham, Amanda Henderson, Elizabeth Beattie
BACKGROUND: Delirium and dementia (cognitive impairment; CI), are common in older hospital patients, and both are associated with serious adverse outcomes. Despite delirium often being preventable, it is frequently not recognized in hospital settings, which may be because hospital nurses have not received adequate education or training in recognizing or caring for those with CI. However, the most effective way of increasing nurses' awareness about delirium and dementia, and initiating regular patient screening and monitoring to guide best practices for these patients in hospital settings is not known...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28278359/qualitative-evaluation-of-a-delirium-prevention-and-management-programme
#10
Yun Kang, Wendy Moyle, Marie Cooke, Siobhan O'Dwyer
AIMS AND OBJECTIVES: To evaluate the effect of an educational programme on registered nurses' knowledge and attitude in delirium care for hospitalised older adults with and without dementia, and to examine the strengths and weaknesses of the programme from the participants' perspectives. BACKGROUND: Providing care for patients with delirium or delirium superimposed on dementia often poses particular challenges such as distinguishing between delirium and dementia for nurses...
March 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28260868/the-diagnosis-of-delirium-in-an-acute-care-hospital-in-moscow-what-does-the-pandora-s-box-contain
#11
Olga N Tkacheva, Nadezda K Runikhina, Arkadiy L Vertkin, Irina V Voronina, Natalia V Sharashkina, Elen A Mkhitaryan, Valentina S Ostapenko, Elena A Prokhorovich, Tamar Freud, Yan Press
BACKGROUND: Delirium, a common problem among hospitalized elderly patients, is not usually diagnosed by doctors for various reasons. The primary aim of this study was to evaluate the effect of a short training course on the identification of delirium and the diagnostic rate of delirium among hospitalized patients aged ≥65 years. The secondary aim was to identify the risk factors for delirium. METHODS: A prospective study was conducted in an acute-care hospital in Moscow, Russia...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28187050/european-society-of-anaesthesiology-evidence-based-and-consensus-based-guideline-on-postoperative-delirium
#12
César Aldecoa, Gabriella Bettelli, Federico Bilotta, Robert D Sanders, Riccardo Audisio, Anastasia Borozdina, Antonio Cherubini, Christina Jones, Henrik Kehlet, Alasdair MacLullich, Finn Radtke, Florian Riese, Arjen J C Slooter, Francis Veyckemans, Sylvia Kramer, Bruno Neuner, Bjoern Weiss, Claudia D Spies
The purpose of this guideline is to present evidence-based and consensus-based recommendations for the prevention and treatment of postoperative delirium. The cornerstones of the guideline are the preoperative identification and handling of patients at risk, adequate intraoperative care, postoperative detection of delirium and management of delirious patients. The scope of this guideline is not to cover ICU delirium. Considering that many medical disciplines are involved in the treatment of surgical patients, a team-based approach should be implemented into daily practice...
April 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28176306/cognitive-differences-between-men-and-women-who-fracture-their-hip-and-impact-on-six-month-survival
#13
Ann L Gruber-Baldini, Mina Hosseini, Denise Orwig, Lynn Grattan, Nancy Chiles Shaffer, Marc Hochberg, Jay Magaziner
OBJECTIVES: There is limited research in cognition and its relationship to mortality after hip fracture among men compared to women. Therefore, the goals of this study were to: (1) compare men and women who fractured their hip on cognition after hospital discharge, and (2) examine the impact of cognition on the differential risk of 6-month mortality between men and women post fracture. DESIGN: Prospective cohort study. SETTING: Eight hospitals in Baltimore, Maryland...
March 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28152732/reducing-pain-agitation-and-delirium-to-optimize-outcomes-in-mechanically-ventilated-critically-ill-oncology-patients
#14
Dana Bullick, Sharon Barniak, Joanne McGovern, Trisha Patel, Jeffrey Hoag
233 Background: Greater than 60% of cancer patients experience chronic pain which is heightened in critical illness. Optimal pain assessment is challenging in the critically ill leading to under treatment due to sedation during mechanical ventilation (MV). The Society of Critical Care Medicine (SCCM) favors treating pain with intermittent boluses rather than continuous infusions; however,appropriate analgesic doses and means of titration are elusive leading to over sedation, prolonged ventilation, and delirium...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28114436/association-of-delirium-with-cognitive-decline-in-late-life-a-neuropathologic-study-of-3-population-based-cohort-studies
#15
Daniel H J Davis, Graciela Muniz-Terrera, Hannah A D Keage, Blossom C M Stephan, Jane Fleming, Paul G Ince, Fiona E Matthews, Colm Cunningham, E Wesley Ely, Alasdair M J MacLullich, Carol Brayne
Importance: Delirium is associated with accelerated cognitive decline. The pathologic substrates of this association are not yet known, that is, whether they are the same as those associated with dementia, are independent, or are interrelated. Objective: To examine whether the accelerated cognitive decline observed after delirium is independent of the pathologic processes of classic dementia. Design, Setting, and Participants: Harmonized data from 987 individual brain donors from 3 observational cohort studies with population-based sampling (Vantaa 85+, Cambridge City Over-75s Cohort, Cognitive Function and Ageing Study) performed from January 1, 1985, through December 31, 2011, with a median follow-up of 5...
March 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28100176/effect-of-training-and-structured-medication-review-on-medication-appropriateness-in-nursing-home-residents-and-on-cooperation-between-health-care-professionals-the-intherakt-study-protocol
#16
Angelika Mahlknecht, Nadja Nestler, Ulrike Bauer, Nadine Schüßler, Jochen Schuler, Sebastian Scharer, Ralf Becker, Isabel Waltering, Georg Hempel, Oliver Schwalbe, Maria Flamm, Jürgen Osterbrink
BACKGROUND: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes...
January 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28095583/is-it-my-job-the-role-of-rns-in-the-assessment-and-identification-of-delirium-in-hospitalized-older-adults-an-exploratory-qualitative-study
#17
Miriam Anne Coyle, Pippa Burns, Victoria Traynor
Delirium is characterized by acute and fluctuating cognitive decline, which is often missed in older adults who are assumed to be experiencing age-related changes or dementia. Delirium affects up to 50% of hospitalized older adults. The aim of the current study was to (a) explore current practices of RNs in assessing and identifying delirium in hospitalized older adults and (b) inform new educational initiatives. Qualitative methods were adopted using eight semi-structured group interviews with 24 RNs. Thematic analysis revealed a dichotomy in practice where RNs described delirium assessment and identification as (a) It's Not My Job, (b) It is My Job, and (c) It's Complex...
April 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28093938/capacity-and-consent
#18
Scott Lamont, Cameron Stewart, Mary Chiarella
INTRODUCTION: Healthcare practitioners have a legal, ethical and professional obligation to obtain patient consent for all healthcare treatments. There is increasing evidence which suggests dissonance and variation in practice in assessment of decision-making capacity and consent processes. AIMS: This study explores healthcare practitioners' knowledge and practices of assessing decision-making capacity and obtaining patient consent to treatment in the acute generalist setting...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/27922747/frailty-and-subsequent-disability-and-mortality-among-patients-with-critical-illness
#19
Nathan E Brummel, Susan P Bell, Timothy D Girard, Pratik P Pandharipande, James C Jackson, Alessandro Morandi, Jennifer L Thompson, Rameela Chandrasekhar, Gordon R Bernard, Robert S Dittus, Thomas M Gill, E Wesley Ely
INTRODUCTION The prevalence of frailty (diminished physiologic reserve) and its effect on outcomes for those ≥18 years old with critical illness is unclear. We hypothesized greater frailty would be associated with subsequent mortality, disability, and cognitive impairment, regardless of age. METHODS At enrollment, we measured frailty using the Clinical Frailty Scale (CFS, range 1 [very fit] to 7 [severely frail]). At 3 and 12 months post-discharge, we assessed vital status, instrumental and basic activities of daily living (IADLs and BADLs), and cognition...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27922474/embracing-a-nurse-driven-alcohol-withdrawal-protocol-through-quality-improvement
#20
John Barrett, Maria Jansen, April Cooper, Matthew Felbinger, Faith Waters
BACKGROUND: Alcohol withdrawal can lead to severe complications including seizures, delirium tremens, and death if not treated appropriately. Nurses are critical to the safety and outcomes of these patients. OBJECTIVE: The objective of this retrospective study was to determine if nursing education on a community hospital's alcohol withdrawal protocol led to improved nursing compliance. METHODS: This is a quality improvement project involving a two-part retrospective review-an initial needs assessment followed by nursing education and a subsequent posteducation retrospective review...
October 2016: Journal of Addictions Nursing
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