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Delirium education

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https://www.readbyqxmd.com/read/28187050/european-society-of-anaesthesiology-evidence-based-and-consensus-based-guidelines-on-postoperative-delirium
#1
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...
February 9, 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
#2
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...
February 8, 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
#3
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
#4
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...
January 18, 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
#5
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
#6
Miriam Anne Coyle, Pippa Burns, Victoria Traynor
HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS XX contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo...
January 17, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28093938/capacity-and-consent
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27902947/what-factors-affect-implementation-of-early-rehabilitation-into-intensive-care-unit-practice-a-qualitative-study-with-clinicians
#10
Selina M Parry, Louisa Remedios, Linda Denehy, Laura D Knight, Lisa Beach, Thomas C Rollinson, Sue Berney, Zudin A Puthucheary, Peter Morris, Catherine L Granger
PURPOSE: To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. MATERIALS AND METHODS: Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. RESULTS: Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork...
November 12, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27890870/improving-the-quality-of-postgraduate-education-in-traditional-japanese-kampo-medicine-for-junior-residents-an-exploratory-survey-conducted-in-five-institutions-in-the-tohoku-area
#11
Shin Takayama, Seiichi Kobayashi, Soichiro Kaneko, Masao Tabata, Shinya Sato, Keiichi Ishikawa, Saya Suzuki, Ryutaro Arita, Natsumi Saito, Tetsuharu Kamiya, Hitoshi Nishikawa, Yuka Ikeno, Junichi Tanaka, Minoru Ohsawa, Akiko Kikuchi, Takehiro Numata, Hitoshi Kuroda, Michiaki Abe, Satoru Ishibashi, Nobuo Yaegashi, Tadashi Ishii
Traditional Japanese (Kampo) medicine has been widely applied in general medicine in Japan. In 2001, the model core curriculum for Japanese medical education was revised to include Kampo medicine. Since 2007, all 80 Japanese medical schools have incorporated it within their programs. However, postgraduate training or instruction of Kampo medicine has not been recognized as a goal for the clinical training of junior residents by Japan's Ministry of Health, Labour and Welfare; little is known about postgraduate Kampo medicine education...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27879983/delirium-a-survey-of-healthcare-professionals-knowledge-beliefs-and-practices
#12
Liron Sinvani, Andrzej Kozikowski, Renee Pekmezaris, Meredith Akerman, Gisele Wolf-Klein
OBJECTIVES: To evaluate knowledge, beliefs, and practices regarding delirium of physicians, nurse practitioners (NPs), and registered nurses (RNs). DESIGN: Anonymous cross-sectional paper survey. SETTING: New York metropolitan area tertiary care hospital. PARTICIPANTS: RNs, NPs, and physicians (N = 164). MEASUREMENTS: The survey assessed knowledge, beliefs, and practices regarding delirium and prior delirium or geriatric training...
December 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27861701/preparing-family-caregivers-to-recognize-delirium-symptoms-in-older-adults-after-elective-hip-or-knee-arthroplasty
#13
Margaret J Bull, Lesley Boaz, Mehdi Maadooliat, Mary E Hagle, Lynn Gettrust, Maureen T Greene, Sue Baird Holmes, Jane S Saczynski
OBJECTIVES: To test the feasibility of a telephone-based intervention that prepares family caregivers to recognize delirium symptoms and how to communicate their observations to healthcare providers. DESIGN: Mixed-method, pre-post quasi-experimental design. SETTING: A Midwest Veterans Affairs Medical Center and a nonprofit health system. PARTICIPANTS: Forty-one family caregiver-older adult dyads provided consent; 34 completed the intervention...
November 11, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27850029/389-impact-of-delirium-education-on-nurses-in-a-community-teaching-hospital
#14
Maria Cardinale, Laura Tewes, Balaji Yegneswaran
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27847677/the-use-of-moca-and-other-cognitive-tests-in-evaluation-of-cognitive-impairment-in-elderly-patients-undergoing-arthroplasty
#15
Jukka Puustinen, Liisa Luostarinen, Markku Luostarinen, Veijo Pulliainen, Heini Huhtala, Marjo Soini, Jaana Suhonen
OBJECTIVE: To examine the prevalence and effect of cognitive impairment on treatment outcomes in elderly patients undergoing arthroplasty and to describe the feasibility of cognitive tests. MATERIALS AND METHODS: The participants were 52 patients with a mean age of 78 years 11 months (SD: 3.3), waiting for primary arthroplasty. We translated Montreal Cognitive Assessment (MoCA) into Finnish and compared it with Mini-Mental State Examination (MMSE), Mini-Cog, and clock-drawing tests prior to and 3 months after the surgery...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/27809575/a-systematic-review-of-postoperative-cognitive-decline-following-open-and-endovascular-aortic-aneurysm-surgery
#16
REVIEW
R A Benson, B A Ozdemir, D Matthews, I M Loftus
OBJECTIVES Postoperative cognitive decline (POCD) is a well-recognised neurological phenomenon following major surgery. Most commonly seen in elderly patients, it has direct links to increased long-term morbidity and reduced quality of life. Its incidence following open and endovascular abdominal and thoracic aneurysm surgery is unclear. The purpose of this systematic review is to collate available evidence for POCD following abdominal and thoracic aortic surgery, and to identify continuing controversies directing future research...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27806548/jordanian-intensive-care-unit-nurses-knowledge-of-delirium-recognition
#17
Mohannad Eid AbuRuz
INTRODUCTION: Delirium is a clinical syndrome that negatively affects the outcomes of the intensive care units patients if undetected early and treated well. However, this condition remains under recognized and poorly managed by health care providers including nurses. The objective of this study was to check nurses' knowledge level about delirium recognition. MATERIALS & METHODS: This was a cross-sectional study on 176 intensive care units nurses working in four major hospitals in Amman, Jordan...
August 26, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27802952/detection-of-posttraumatic-stress-symptoms-in-patients-after-discharge-from-intensive-care
#18
Heather Warlan, Lois Howland, Cynthia Connelly
BACKGROUND: Despite emphasis on identifying personal and clinical characteristics that place patients at higher risk for posttraumatic stress syndrome after intensive care, the extent of screening for the syndrome in intensive care patients is unknown. OBJECTIVES: To examine the feasibility and acceptability of a screening tool to detect posttraumatic stress syndrome, screen for the syndrome soon after discharge from intensive care to identify patients at risk for post-traumatic stress disorder, and determine personal and clinical factors related to higher scores on the screening instrument...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27791223/non-pharmacological-interventions-to-prevent-or-treat-delirium-in-older-patients-clinical-practice-recommendations-the-senator-ontop-series
#19
I Abraha, J M Rimland, F Trotta, V Pierini, A Cruz-Jentoft, R Soiza, D O'Mahony, A Cherubini
DESCRIPTION: The ONTOP project aims to undertake a literature search of systematic reviews concerning evidence-based non-pharmacological interventions of prevalent medical conditions affecting older people, including delirium. OBJECTIVES: To develop explicit and transparent recommendations for non-pharmacological interventions in older subjects at risk of developing delirium, as well as in older subjects with delirium, based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to rating the quality of evidence and the strength of recommendations...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27766513/risk-factors-for-postoperative-delirium-after-spine-surgery-in-middle-and-old-aged-patients
#20
Xin Jiang, Dong Chen, Yahao Lou, Zhongshi Li
BACKGROUND: Postoperative delirium is a common complication following various operative procedures with an incidence rate of 10-77 %. AIM: To analyze various risk factors for postoperative delirium after spine surgery in the middle- and old-aged patients. METHODS: This study retrospectively reviewed 451 patients (226 males and 225 females, an average age of 65.1 ± 18.3 years) who underwent spinal surgery in our hospital between January 2010 and August 2015...
October 20, 2016: Aging Clinical and Experimental Research
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