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Delirium education

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https://www.readbyqxmd.com/read/29213507/sundown-syndrome-and-symptoms-of-anxiety-and-depression-in-hospitalized-elderly
#1
Marcello Weynes Barros Silva, Rilva Lopes Sousa-Muñoz, Heitor Cabral Frade, Priscilla Alencar Fernandes, Andrêssa de Oliveira Magalhães
Sundown syndrome is characterized by the sudden appearance of neuropsychiatric symptoms such as agitation, confusion and anxiety in a chronologic fashion, usually during late afternoon or early evening. Objective: To evaluate the prevalence of sundown syndrome in university hospital wards and its relationship with anxiety/depression symptoms, cognitive decline, and clinical and demographic variables. Methods: We evaluated 70 patients admitted to the Lauro Wanderley University Hospital (HULW), João Pessoa-PB, Brazil...
April 2017: Dementia & Neuropsychologia
https://www.readbyqxmd.com/read/29196594/perceptions-of-families-of-intensive-care-unit-patients-regarding-involvement-in-delirium-prevention-activities-a-qualitative-study
#2
Pamela L Smithburger, Amanda S Korenoski, Sheila A Alexander, Sandra L Kane-Gill
BACKGROUND: Nonpharmacologic delirium-prevention strategies are commonly used in the intensive care unit by bedside nurses. With up to 80% of intensive care unit patients becoming delirious, and lacking treatment options, prevention is key. However, with increasing nurse workloads, innovative delirium-prevention strategies such as involving the patient's family are needed. OBJECTIVE: To gain insight into opinions of patients' families regarding active participation in delirium-prevention activities to inform specific recommendations for involving patients' families in such activities...
December 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/29136301/ketamine-for-the-acute-management-of-excited-delirium-and-agitation-in-the-prehospital-setting
#3
Kyle A Weant, Lauren M Linder, Clint A Ross
BACKGROUND: Traditional first-line therapy in the prehospital setting for the acutely agitated patient includes an antipsychotic in combination with a benzodiazepine. Recently, interest has grown regarding the use of ketamine in the prehospital setting as an attempt to overcome the limitations of the traditional medications and provide a more safe and effective therapy. This review provides an overview of the pharmacology of ketamine, evaluates the literature regarding ketamine use for prehospital agitation, and proposes an algorithm that may be used within the prehospital setting...
November 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29124114/impact-of-programs-to-reduce-antipsychotic-and-anticholinergic-use-in-nursing-homes
#4
Ryan M Carnahan, Grant D Brown, Elena M Letuchy, Linda M Rubenstein, Brian M Gryzlak, Marianne Smith, Jeffrey C Reist, Michael W Kelly, Susan K Schultz, Michelle T Weckmann, Elizabeth A Chrischilles
Introduction: Antipsychotics are used for managing behavioral and psychological symptoms of dementia (BPSD) but have risks. Anticholinergics can worsen outcomes in dementia. The Improving Antipsychotic Appropriateness in Dementia Patients educational program (IA-ADAPT) and Centers for Medicare and Medicaid Services Partnership to Improve Dementia Care (CMS Partnership) promote improved care for BPSD. The purpose of this study was to evaluate the impact of these programs on medication use and BPSD among nursing home residents...
November 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/29092867/subsyndromal-delirium-and-institutionalization-among-patients-with-critical-illness
#5
Nathan E Brummel, Leanne M Boehm, Timothy D Girard, Pratik P Pandharipande, James C Jackson, Christopher G Hughes, Mayur B Patel, Jin H Han, Eduard E Vasilevskis, Jennifer L Thompson, Rameela Chandrasekhar, Gordon R Bernard, Robert S Dittus, E Wesley Ely
BACKGROUND: The prognostic importance of subsyndromal delirium is unknown. OBJECTIVE: To test whether duration of subsyndromal delirium is independently associated with institutionalization. METHODS: The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was used twice daily to assess for subsyndromal delirium in patients with respiratory failure or shock. Delirium was considered present if the assessment was positive. Subsyndromal delirium was considered present if the assessment was negative but the patient exhibited any CAM-ICU features...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29061098/the-cognitive-reserve-model-in-the-development-of-delirium-the-successful-aging-after-elective-surgery-study
#6
Sevdenur Cizginer, Edward Marcantonio, Sarinnapha Vasunilashorn, Alvaro Pascual-Leone, Mouhsin Shafi, Eva M Schmitt, Sharon K Inouye, Richard N Jones
We evaluated the role of cognitive and brain reserve markers in modifying the risk of postoperative delirium associated with a pathophysiologic marker. The Successful Aging after Elective Surgery study (SAGES) enrolled 556 adults age ≥70 years without dementia scheduled for major surgery. Patients were assessed preoperatively and daily during hospitalization for delirium. We used C-reactive protein (CRP) as a pathophysiologic marker of inflammation, previously associated with delirium. Markers of reserve included vocabulary knowledge, education, cognitive activities, occupation type and complexity, head circumference, intracranial volume, and leisure activities...
November 2017: Journal of Geriatric Psychiatry and Neurology
https://www.readbyqxmd.com/read/29054400/barriers-to-delirium-assessment-in-the-intensive-care-unit-a-literature-review
#7
REVIEW
Gabby Rowley-Conwy
BACKGROUND: Delirium is a common syndrome that has both short and long-term negative outcomes for critically ill patients. Many studies over several years have found a knowledge gap and lack of evidence-based practice from critical care personnel, but there has been little exploration of the reasons for this. AIM: To identify the perceived barriers to delirium assessment and management among critical care nurses. METHOD: A literature review of published studies to examine barriers to effective delirium assessment using a comprehensive search strategy...
October 17, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29028151/delirium-care-real-world-solutions-to-real-world-problems
#8
Eamonn Eeles, Judy McCrow, Andrew Teodorczuk, Gideon A Caplan
OBJECTIVES: Implementation research into delirium care is lacking. Exploiting known practice barriers to understand what management strategies work best in delirium is a means of prioritising care interventions. A consensus approach to determining priority interventions in delirium was derived and related to reference standards in health-care practice. METHODS: A workshop of 20 experts was held at the Australasian Delirium Association conference 2016. Structured small group work, iterative ranking and a 21-member check were undertaken to (i) explore research barriers in delirium care; (ii) explore how barriers related to individual items of multicomponent interventions; and (iii) rank multicomponent interventions in relation to each statement within the newly released Australian Commission on Safety and Quality in Health Care delirium standard...
October 13, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28985242/development-of-an-international-undergraduate-curriculum-for-delirium-using-a-modified-delphi-process
#9
Claire Copeland, James Fisher, Andrew Teodorczuk
Background: delirium is a medical emergency affecting approximately 30% of hospitalised older patients. Recent work examining UK undergraduate medical curricula highlighted inconsistencies in the delivery of teaching on delirium. The aim of this project was to develop consensus agreement on a delirium curriculum for medical undergraduates. Methods: a modified Delphi process was used to determine consensus amongst experts in an iterative manner. Experts at the European Delirium Association Conference (London, 2015) were invited to participate...
August 9, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28971468/post-operative-delirium-in-elderly-people-diagnostic-and-management-issues-of-post-operative-delirium-in-elderly-people
#10
Christina Florou, Dimitrios Theofilopoulos, Styliani Tziaferi, Maria Chania
Hippocrates a Greek physician commonly known as the Father of Medicine was the first to describe delirium, 'phrenitis', differencing it from other disorders such as melancholia and mania. Since then, it still remains a clinical problem which is not yet resolved.Postoperative delirium is a common medical problem that occurs preferentially in surgical patients aged 65 years and older. It is a true medical emergency that requires immediate professional attention and treatment. Faced by health professionals and especially nurses it is often undetected, misdiagnosed, and under-treated as a complication by them during clinical care...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28959786/a-quality-improvement-approach-to-cognitive-assessment-on-hospice-admission-could-we-use-the-4at-or-short-cam
#11
Lucy Baird, Juliet Anne Spiller
Background Prevalence studies show that 13%-42% of patients admitted to specialist palliative care inpatient units have delirium. Symptoms of delirium are often subtle and easily missed, or misdiagnosed as fatigue or depression, and so the use of a screening tool could improve early identification and management of delirium and lead to improved outcomes. Patients admitted to hospices are often frail and tired, therefore a quick and easy-to-use method of cognitive assessment is essential. Methods A quality improvement (QI) approach (PDSA: Plan, Do, Study, Act) was used to improve screening for delirium on admission to a hospice unit...
2017: BMJ Open Quality
https://www.readbyqxmd.com/read/28953621/perceptions-attitudes-and-current-practices-regards-delirium-in-china-a-survey-of-917-critical-care-nurses-and-physicians-in-china
#12
Jinyan Xing, Yunbo Sun, Yaqi Jie, Zhiyong Yuan, Wenjuan Liu
The purpose of this study is to assess the knowledge, attitudes, and managements regarding delirium of intensive care nurses and physicans, and to assess the perceived barriers related to intensive care unit (ICU) delirium monitoring in China. A descriptive survey was distributed to 1156 critical care nurses and physicians from 74 tertiary and secondary hospitals across Shandong province, China. The overall response rate was 86.18% (n = 917). The majority of respondents (88%) believed that deirium was associated with prolonged mechanical ventilation, and 79...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28918164/telepsychiatry-consultation-for-medical-and-surgical-inpatient-units
#13
Julie A Graziane, Priya Gopalan, Jack Cahalane
BACKGROUND: Telepsychiatry is becoming more commonplace in the provision of psychiatric care. Most commonly used in the outpatient setting, there is little information available in the literature as to the use of telepsychiatry for inpatient medical/surgical consultation. OBJECTIVE: We review the University of Pittsburgh Medical Center's telepsychiatry consultation program that provides consultation to an outlying community-based rural hospital. METHODS: This article examines the 69 telepsychiatry consultations that were performed from November 2014 through February 2016, looking at the patients served, common consultation questions, and patterns of diagnoses and recommendations...
August 12, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28904548/effect-of-family-patient-communication-on-the-incidence-of-delirium-in-hospitalized-patients-in-cardiovascular-surgery-icu
#14
Maryam Eghbali-Babadi, Nasrin Shokrollahi, Tayebe Mehrabi
BACKGROUND: Cardiovascular diseases are the most important causes of morbidity and mortality in the world, and cardiac surgery is one of the treatments that have complication for patients. One of the most important current psychological complications after cardiac surgery is delirium. For its prevention and treatment, considerable attention should be paid to the role of family. This study has been conducted for assessing the effect of the relationship between the family and patient on the incidence of delirium in hospitalized patients in cardiovascular surgery intensive care unit (ICU) of Isfahan Shahid Chamran hospital...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28876970/responding-to-ten-common-delirium-misconceptions-with-best-evidence-an-educational-review-for-clinicians
#15
Mark A Oldham, Nina M Flanagan, Ariba Khan, Olga Boukrina, Edward R Marcantonio
Delirium (acute confusion) is a serious, common health condition, and it predicts poor outcomes, including greater rates of mortality, institutionalization, prolonged hospitalization, and cognitive impairment. Expedient diagnosis and management are critical to address modifiable delirium causes and improve both quality of care and outcomes. Moreover, more than a third of delirium is preventable. Despite the clear significance of delirium and our increasingly sophisticated understanding of the condition, the gap between evidence and practice persists...
September 6, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28854542/association-between-delirium-and-cognitive-change-after-cardiac-surgery
#16
A C Sauër, D S Veldhuijzen, T H Ottens, A J C Slooter, C J Kalkman, D van Dijk
Background: Previous studies provide inconsistent data on whether postoperative delirium (POD) is a risk factor for postoperative cognitive decline (POCD). We thus investigated the relationship between POD and cognitive change after cardiac surgery and assessed the relationship between preoperative cognitive domain scores and POD. Methods: Postoperative delirium was assessed with the Confusion Assessment Method (CAM) adapted for the intensive care unit and the conventional CAM accompanied by chart review...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28854531/postoperative-delirium-in-elderly-patients-is-associated-with-subsequent-cognitive-impairment
#17
J Sprung, R O Roberts, T N Weingarten, A Nunes Cavalcante, D S Knopman, R C Petersen, A C Hanson, D R Schroeder, D O Warner
Background: We examined the risk for postoperative delirium (POD) in patients with mild cognitive impairment (MCI) or dementia, and the association between POD and subsequent development of MCI or dementia in cognitively normal elderly patients. Methods: Patients ≥65 yr of age enrolled in the Mayo Clinic Study of Aging who were exposed to any type of anaesthesia from 2004 to 2014 were included. Cognitive status was evaluated before and after surgery by neuropsychological testing and clinical assessment, and was defined as normal or MCI/dementia...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28843527/factors-associated-with-the-trend-of-physical-and-chemical-restraint-use-among-long-term-care-facility-residents-in-hong-kong-data-from-an-11-year-observational-study
#18
Kuen Lam, Joseph S K Kwan, Chi Wai Kwan, Alice M L Chong, Claudia K Y Lai, Vivian W Q Lou, Angela Y M Leung, Justina Y W Liu, Xue Bai, Iris Chi
BACKGROUND: Negative effects of restraint use have been well-documented. However, the prevalence of restraints use has been high in long-term care facilities in Hong Kong compared with other countries and this goes against the basic principles of ethical and compassionate care for older people. The present study aimed to review the change in the prevalence of physical and chemical restraint use in long-term care facilities (LTCFs) over a period of 11 years in Hong Kong and to identify the major factors associated with their use...
August 23, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28795670/-analysis-of-the-risk-factors-of-cognitive-impairment-in-post-intensive-care-syndrome-patient
#19
Cong Shao, Lixue Gu, Yongxia Mei, Mingjin Li
OBJECTIVE: To investigate the risk factors of cognitive impairment in post-intensive care syndrome patient (PICS-CI). METHODS: A retrospective study was conducted. The patient who transferred from post-intensive care unit (ICU) to the general ward for more than 7 days, and with the age ≥ 18 years old in the First Affiliated Hospital of Jinzhou Medical University from October 2015 to November 2016 were enrolled. The gender, age, marital status, education, occupation, salary, economic income, smoking, alcohol drinking, previous of history, mechanical ventilation, the length of ICU stay, sedative and delirium, and initial diagnosis were recorded...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28743149/-the-influence-of-anesthesia-on-perioperative-outcome-in-children-institutional-and-individual-factors
#20
Frank Fideler, Christian Grasshoff
The perioperative care of children is challenging for health care providers. Since anesthetists cannot affect the nature of the disease and have hardly an impact on the decision for surgery we summarized in this review individual and institutional factors for improving perioperative outcome by anesthetists. Individual factors include the level of education and the professional experience of the anesthetist as well as an anesthetic management that is focused on the maintenance of an adequate cerebral perfusion...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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