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Delirium education

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https://www.readbyqxmd.com/read/28700075/south-korean-family-caregiver-involvement-in-delirium-care-a-qualitative-descriptive-study
#1
Yun Kang, Wendy Moyle, Marie Cooke, Siobhan O'Dwyer
The current study aimed to describe the effect of an educational program on RN-initiated efforts to involve family caregivers in delirium care. A descriptive qualitative study was performed. A purposive sample of 12 RNs who participated in a one group, pre-post evaluation of a delirium educational program, and a nominated sample of six family caregivers of patients who had been cared for by RNs in the program participated in individual, in-depth interviews. The qualitative findings indicated that the inclusion of a delirium brochure in ward orientation on admission, with reinforcement during shift changes, and RN-initiated engagement with family caregivers promoted family caregiver involvement in delirium prevention...
July 12, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28692620/delirium-in-the-icu-what-about-the-floor
#2
Anthony Cahill, Christopher Pearcy, Vaidehi Agrawal, Phillip Sladek, Michael S Truitt
Delirium was first described in the 1800s as acute, fluctuating confusion. Recent studies note an incidence of 15% in adult intensive care unit patients. Here we present the first prospective study to evaluate the incidence and risk factors for delirium in patients admitted to the trauma surgeon (TS) in non-critical care areas (NCCAs). Patients 18 years or older admitted to any TS in the designated NCCA were evaluated and consented for participation over a 3-month period. Participants were screened with the Confusion Assessment Method (CAM) every 12 hr...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28677230/delirium-in-a-residential-care-facility-an-exploratory-study-of-staff-knowledge
#3
Amy Buettel, Michelle Cleary, Marguerite Bramble
OBJECTIVE: To explore staff knowledge of delirium by eliciting meaning through descriptions of their experiences within a residential aged care facility (RACF). METHODS: Six staff from one RACF in Australia participated in this qualitative study. Semi-structured individual interviews were conducted and analysed using Colaizzi's analytical framework. RESULTS: The analysis revealed four themes: (i) absence of the word delirium; (ii) care based on intuition and automated actions; (iii) reliance on teamwork; and (iv) confusing delirium, depression and dementia...
July 5, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28655417/-functional-impairment-associated-with-cognitive-impairment-in-hospitalised-elderly
#4
José Mauricio Ocampo-Chaparro, José Ignacio Mosquera-Jiménez, Annabelle S Davis, Carlos A Reyes-Ortiz
INTRODUCTION: The aim of this study was to analyse the effect of cognitive impairment on functional decline in hospitalised patients aged ≥60 years. METHODS: Measurements at admission included demographic data, Charlson's comorbidity index, and cognitive impairment (according to education level). Data were also collected on hospital length of stay, depression, and delirium developed during hospitalisation. The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge...
June 24, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28645616/epidemiological-and-sociodemographic-factors-associated-with-complicated-alcohol-withdrawal-syndrome
#5
R Monte-Secades, M Blanco-Soto, J A Díaz-Peromingo, A Sanvisens-Bergé, M C Martín-González, A Barbosa, B Rosón-Hernández, M A Tejero-Delgado, R Puerta-Louro, R Rabuñal-Rey
OBJECTIVES: To analyse the influence of epidemiological and sociodemographic factors in complicated alcohol withdrawal syndrome (AWS). MATERIAL AND METHODS: A multicentre, observational prospective study was conducted on consecutively added patients with AWS hospitalised in internal medicine departments. We recorded sociodemographic, epidemiological, clinical and progression data. Complicated AWS was defined as that which progressed with seizures or delirium tremens...
June 20, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28642002/development-of-geriatric-mental-health-learning-objectives-for-medical-students-a-response-to-the-institute-of-medicine-2012-report
#6
Susan W Lehmann, William B Brooks, Dennis Popeo, Kirsten M Wilkins, Mary C Blazek
America is aging as the population of older adults increases. The shortage of geriatric mental health specialists means that most geriatric mental healthcare will be provided by physicians who do not have specialty training in geriatrics. The Institute of Medicine Report of 2012 highlighted the urgent need for development of national competencies and curricula in geriatric mental health for all clinicians. Virtually all physicians can expect to treat older patients with mental health symptoms, yet currently there are no widely accepted learning objectives in geriatric mental health specific for medical students...
May 12, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28593326/intraoperative-infusion-of-dexmedetomidine-for-prevention-of-postoperative-delirium-and-cognitive-dysfunction-in-elderly-patients-undergoing-major-elective-noncardiac-surgery-a-randomized-clinical-trial
#7
Stacie Deiner, Xiaodong Luo, Hung-Mo Lin, Daniel I Sessler, Leif Saager, Frederick E Sieber, Hochang B Lee, Mary Sano, Christopher Jankowski, Sergio D Bergese, Keith Candiotti, Joseph H Flaherty, Harendra Arora, Aryeh Shander, Peter Rock
Importance: Postoperative delirium occurs in 10% to 60% of elderly patients having major surgery and is associated with longer hospital stays, increased hospital costs, and 1-year mortality. Emerging literature suggests that dexmedetomidine sedation in critical care units is associated with reduced incidence of delirium. However, intraoperative use of dexmedetomidine for prevention of delirium has not been well studied. Objective: To evaluate whether an intraoperative infusion of dexmedetomidine reduces postoperative delirium...
June 7, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28542707/-urinary-tract-infection-requiem-for-a-heavyweight
#8
Thomas E Finucane
"Urinary tract infection" ("UTI") is an ambiguous, expansive, overused diagnosis that can lead to marked, harmful antibiotic overtreatment. "Significant bacteriuria," central to most definitions of "UTI," has little significance in identifying individuals who will benefit from treatment. "Urinary symptoms" are similarly uninformative. Neither criterion is well defined. Bacteriuria and symptoms remit and recur spontaneously. Treatment is standard for acute uncomplicated cystitis and common for asymptomatic bacteriuria, but definite benefits are few...
May 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28508438/the-effect-of-chronotherapy-on-delirium-in-critical-care%C3%A2-%C3%A2-a-systematic-review
#9
Roseanne Luther, Anne McLeod
BACKGROUND: Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units. AIM: This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care? DESIGN: This study is a systematic review of quantitative studies...
May 15, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28506741/evaluation-of-a-sound-environment-intervention-in-an-icu-a-feasibility-study
#10
Lotta Johansson, Berit Lindahl, Susanne Knutsson, Mikael Ögren, Kerstin Persson Waye, Mona Ringdal
BACKGROUND: Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes. OBJECTIVES: (1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms...
May 12, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28506544/development-of-the-vanderbilt-assessment-for-delirium-in-infants-and-children-to-standardize-pediatric-delirium-assessment-by-psychiatrists
#11
REVIEW
Maalobeeka Gangopadhyay, Heidi Smith, Maryland Pao, Gabrielle Silver, Deepmala Deepmala, Claire De Souza, Georgina Garcia, Lisa Giles, Danica Denton, Natalie Jacobowski, Pratik Pandharipande, Catherine Fuchs
BACKGROUND: Pediatric delirium assessment is complicated by variations in baseline language and cognitive skills, impairment during illness, and absence of pediatric-specific modifiers within the Diagnostic and Statistical Manual of Mental Disorders delirium criterion. OBJECTIVE: To develop a standardized approach to pediatric delirium assessment by psychiatrists. METHODS: A multidisciplinary group of clinicians used Diagnostic and Statistical Manual criterion as the foundation for the Vanderbilt Assessment for Delirium in Infants and Children (VADIC)...
July 2017: Psychosomatics
https://www.readbyqxmd.com/read/28485318/a-national-multicenter-survey-on-management-of-pain-agitation-and-delirium-in-intensive-care-units-in-china
#12
Jing Wang, Zhi-Yong Peng, Wen-Hai Zhou, Bo Hu, Xin Rao, Jian-Guo Li
BACKGROUND: The management of pain, agitation, and delirium (PAD) in Intensive Care Unit (ICU) is beneficial for patients and makes it widely applied in clinical practice. Previous studies showed that the clinical practice of PAD in ICU was improving; yet relatively little information is available in China. This study aimed to investigate the practice of PAD in ICUs in China. METHODS: A multicenter, nationwide survey was conducted using a clinician-directed questionnaire from September 19 to December 18, 2016...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28466701/care-of-patients-with-dementia-in-an-acute-trauma-and-orthopaedics-unit
#13
Gillian McCorkell, Deirdre Harkin, Victoria McCrory, Mary Lafferty, Vivien Coates
Aim To increase awareness of the needs of patients with dementia in the trauma and orthopaedics unit of one acute hospital, and to collaborate with staff on the unit to identify ways of improving the care experienced by these patients and their families. Method An action research approach was used and three action research cycles were completed. Data were obtained retrospectively for 20 patients with dementia who were admitted to the unit for treatment. Deficiencies in the care of these patients were identified and related to communication, pain management and the recognition of delirium...
May 3, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28459497/assessment-of-delirium-in-intensive-care-unit-patients-educational-strategies
#14
Judith M Smith, M Nancy Van Aman, Mary Elizabeth Schneiderhahn, Robin Edelman, Patrick M Ercole
BACKGROUND: Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently. METHOD: A pretest-posttest design was used to evaluate the success of a multimodal educational strategy (i...
May 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28458577/ambulatory-anesthetic-care-in-children-undergoing-myringotomy-and-tube-placement-current-perspectives
#15
REVIEW
Hal Robinson, Thomas Engelhardt
PURPOSE: Myringotomy and tube placement is one of the most frequently performed ear, nose and throat (ENT) surgeries in the pediatric population. Effective anesthetic management is vital to ensuring successful ambulatory care and ensuring child and parental satisfaction. RECENT FINDINGS: This review summarizes recently published studies about the long-term effects of general anesthesia in young children, novel approaches to preoperative fasting and simplified approaches to the assessment and management of emergence delirium (ED) and emergence agitation (EA)...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28449827/meeting-its-mission-does-psychosomatics-align-with-the-mission-of-its-parent-organization-the-academy-of-psychosomatic-medicine
#16
John B Taylor, Theodore A Stern
BACKGROUND: The vision and mission statements of the Academy of Psychosomatic Medicine (APM) indicate that the APM should promote excellence in clinical care for patients with comorbid psychiatric and general medical conditions by seeking to influence research, public policy, and interdisciplinary education. OBJECTIVE: As the APM owns the journal, Psychosomatics, we sought to assess whether the APM's journal was fulfilling the vision and mission of its parent organization by reviewing the content of articles published in the journal to determine whether it sufficiently addresses the various clinical care knowledge areas it seeks to influence...
March 8, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28447103/comparison-of-clinical-outcomes-following-head-and-neck-surgery-among-patients-who-contract-to-abstain-from-alcohol-vs-patients-who-abuse-alcohol
#17
Azeem S Kaka, Songzhu Zhao, Enver Ozer, Amit Agrawal, Stephen Kang, James Rocco, Ricardo Carrau, Theodoros Teknos, John D Clapp, Harrison Weed, Matthew O Old
Importance: Alcohol abuse is highly prevalent in the population of patients with head and neck cancer, and active abuse at the time of surgery results in poor postoperative outcomes. Objective: To determine the association of alcohol abstinence with postoperative outcome in alcohol misusers undergoing major surgical procedures of the head and neck. Design, Setting, and Participants: As a case-control study, from July 2013 to August 2015, outcomes were collected in patients at an academic tertiary referral center requiring free flap reconstruction who had undergone an abstinence contract (n = 15) and compared with those who were abusers of alcohol prior to the inception of the protocol (n = 30)...
April 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28436344/inattention-tests-for-delirium
#18
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
#19
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
#20
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...
June 2017: Pediatric Critical Care Medicine
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