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Delirium education

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https://www.readbyqxmd.com/read/29390969/hypertension-mitral-valve-disease-atrial-fibrillation-and-low-education-level-predict-delirium-and-worst-outcome-after-cardiac-surgery-in-older-adults
#1
Fátima R Oliveira, Victor H Oliveira, Ítalo M Oliveira, José W Lima, Daniela Calderaro, Danielle M Gualandro, Bruno Caramelli
BACKGROUND: Delirium is a common complication after cardiac surgery in older adult patients. However, risk factors and the influence of delirium on patient outcomes are not well established. We aimed to determine the incidence, predisposing and triggering factors of delirium following cardiac surgery. METHODS: One hundred seventy-three consecutive patients aged ≥60 years were studied. Patients' characteristics and two cognitive function assessment tests were recorded preoperatively...
February 1, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29351772/effect-of-an-interactive-e-learning-tool-for-delirium-on-patient-and-nursing-outcomes-in-a-geriatric-hospital-setting-findings-of-a-before-after-study
#2
Elke Detroyer, Fabienne Dobbels, Andrew Teodorczuk, Mieke Deschodt, Yves Depaifve, Etienne Joosten, Koen Milisen
BACKGROUND: Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present. Aim is to determine the effect of a nursing e-learning tool for delirium on: (1) in-hospital prevalence, duration and severity of delirium or mortality in hospitalized geriatric patients, and (2) geriatric nurses' knowledge and recognition regarding delirium...
January 19, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29346380/rapidly-progressive-dementia-an-eight-year-2008-2016-retrospective-study
#3
Patil Anuja, Vishnu Venugopalan, Naheed Darakhshan, Pandit Awadh, Vinny Wilson, Goyal Manoj, Modi Manish, Lal Vivek
BACKGROUND AND PURPOSE: Rapidly progressive dementia (RPD) is an emergency in cognitive neurology, defined as cognitive impairment affecting the daily living activities developed over less than 1 year. This study investigated the profile of patients with rapidly progressive dementia at first presentation. METHODS: Retrospective case analysis was done in 187 patients with rapidly progressive dementia who presented to the Postgraduate Institute of Medical Education and Research, Chandigarh, India from January 2008 to August 2016...
2018: PloS One
https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#4
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
January 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29317807/pain-assessment-in-impaired-cognition-paic-content-validity-of-the-dutch-version-of-a-new-and-universal-tool-to-measure-pain-in-dementia
#5
Annelore H van Dalen-Kok, Wilco P Achterberg, Wieke E Rijkmans, Sara A Tukker-van Vuuren, Suzanne Delwel, Henrica Cw de Vet, Frank Lobbezoo, Margot Wm de Waal
Objectives: Detection and measurement of pain in persons with dementia by using observational pain measurement tools is essential. However, the evidence for the psychometric properties of existing observational tools remains limited. Therefore, a new meta-tool has been developed: Pain Assessment in Impaired Cognition (PAIC), as a collaborative EU action. The aim is to describe the translation procedure and content validity of the Dutch version of the PAIC. Methods: Translation of the PAIC into Dutch followed the forward-backward approach of the Guidelines for Establishing Cultural Equivalence of Instruments...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29314374/falls-and-delirium-in-an-acute-care-setting-a-retrospective-chart-review-before-and-after-an-organization-wide-interprofessional-education
#6
Rhonda L Babine, Kristiina E Hyrkäs, Sarah Hallen, Heidi R Wierman, Deborah A Bachand, Joanne L Chapman, Valerie J Fuller
AIM AND OBJECTIVES: To describe and compare identification of delirium, length of stay, and discharge locations in two patient samples of falls, before and after an organization wide interprofessional delirium education and practice change along with implementation of a policy. BACKGROUND: Delirium is a common and severe problem for hospitalized patients, with occurrence ranging from 14-56%, morbidity and mortality from 25-33%. Recent studies report that 73-96% of patients who fell during a hospital stay had symptoms of delirium; however the delirium went undiagnosed and untreated in 75% of the cases...
January 4, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29306752/turning-education-into-action-impact-of-a-collective-social-education-approach-to-improve-nurses-ability-to-recognize-and-accurately-assess-delirium-in-hospitalized-older-patients
#7
Catherine Travers, Amanda Henderson, Fred Graham, Elizabeth Beattie
BACKGROUND: Although cognitive impairment including dementia and delirium is common in older hospital patients, it is not well recognized or managed by hospital staff, potentially resulting in adverse events. This paper describes, and reports on the impact of a collective social education approach to improving both nurses' knowledge of, and screening for delirium. METHODS: Thirty-four experienced nurses from six hospital wards, became Cognition Champions (CogChamps) to lead their wards in a collective social education process about cognitive impairment and the assessment of delirium...
December 29, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29287672/-impact-of-hypotension-and-global-hypoperfusion-in-postoperative-delirium-a-pilot-study-in-older-adults-undergoing-open-colon-surgery
#8
Eduardo Tobar, Mario A Abedrapo, Jaime A Godoy, Jose L Llanos, Mauricio J Díaz, Rodrigo Azolas, Gunther R Bocic, Jaime A Escobar, Rodrigo A Cornejo, Carlos M Romero
BACKGROUND: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium. METHODS: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery...
December 26, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29234918/patients-with-dementia-in-acute-care-hospitals-a%C3%A2-cross-sectional-study-of-physicians-experiences-and-attitudes
#9
Lena Helm, Katrin Balzer, Anja Behncke, Nora Eisemann, Sascha Köpke
BACKGROUND: Patients with dementia (PwD) are a vulnerable group and caring for these patients in acute care hospitals is challenging. Structural conditions and standardized treatment procedures in hospitals often do not correspond to the needs of this patient group. Physicians may not be well prepared for caring for PwD. OBJECTIVE: This study aimed to ascertain physicians' experiences and attitudes in caring for PwD or cognitive disorders and their subjective workload...
December 12, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29213507/sundown-syndrome-and-symptoms-of-anxiety-and-depression-in-hospitalized-elderly
#10
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
#11
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
#12
REVIEW
Lauren M Linder, Clint A Ross, Kyle A Weant
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...
January 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29124114/impact-of-programs-to-reduce-antipsychotic-and-anticholinergic-use-in-nursing-homes
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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