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Delirium assessment

Jayita De, Anne P F Wand, Peter I Smerdely, Glenn E Hunt
OBJECTIVE: To measure the diagnostic accuracy of the 4A's test in screening for delirium in geriatric inpatients from culturally diverse backgrounds. METHODS: A prospective study was conducted with patients admitted to the geriatric and orthogeriatric services of a tertiary teaching hospital. Consenting participants aged 65 years and over were screened for delirium with the 4AT by nursing staff within 72 h of admission. The diagnosis of delirium was made separately by expert assessors, responsible for the participant's clinical care, blinded to the 4AT score, within 30 min of the 4AT assessment using the DSM 5 criteria and the Confusion Assessment Method...
October 20, 2016: International Journal of Geriatric Psychiatry
Yimin Qiu, Dongmei Chen, Xiaojing Huang, Lina Huang, Liang Tang, Jihong Jiang, Lianhua Chen, Shitong Li
BACKGROUND: Limited surveys have assessed the performance of 5-hydroxytreptamine receptor 1A and its antagonist WAY-100635 in pharmacological manipulations targeting delirium therapies. The purpose of this paper was to assess the central pharmacological activity of WAY-100635 in a rat model of scopolamine-induced delirium and its underlying mechanism. RESULTS: A delirium rat model was established by intraperitoneal injection of scopolamine and behavioral changes evaluated through open field and elevated plus maze experiments...
October 19, 2016: BMC Neuroscience
Karen E van den Hondel, Anne Linde Saaltink, Peter Paul M Bender
BACKGROUND: Forensic physicians are responsible for first-line medical care of detainees (individuals held in custody) in the police station. The Dutch police law contains a 'duty of care', which gives the police responsibility for the apparent mentally ill and/or confused people they encounter during their work. The police can ask a forensic physician to do a primary psychiatric assessment of any apparent mentally ill detainee. The forensic physician determines if the apparent mentally ill behavior of the detainee is due to a somatic illness, or has a psychiatric cause for which the detainee needs admission to a psychiatric hospital...
October 11, 2016: Journal of Forensic and Legal Medicine
Susana Vacas, Vincent Degos, Mervyn Maze
BACKGROUND: Sleep is integral to biologic function, and sleep disruption can result in both physiological and psychologic dysfunction including cognitive decline. Surgery activates the innate immune system, inducing neuroinflammatory changes that interfere with cognition. Because surgical patients with sleep disorders have an increased likelihood of exhibiting postoperative delirium, an acute form of cognitive decline, we investigated the contribution of perioperative sleep fragmentation (SF) to the neuroinflammatory and cognitive responses of surgery...
October 11, 2016: Anesthesia and Analgesia
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
Floriana Pinto, Gianni Biancofiore
BACKGROUND: The ABCDE (Awakening and Breathing coordination of daily sedation and ventilator removal trials; Choice of sedative or analgesic exposure; Delirium monitoring and management; and Early mobility and exercise) bundle is a multidisciplinary set of evidence-based practices for improving patient outcomes in the intensive care unit. Nurses are critical to all the bundle's requirements. Therefore, understanding their knowledge, attitudes, and perception of the different bundle's components might help for an easier implementation into everyday clinical practice...
November 2016: Dimensions of Critical Care Nursing: DCCN
Huimin Lin, Samuel T H Chew
An 85-year-old female with chronic kidney disease and newly acquired seizures on oral phenytoin received intravenous ertapenem 500 mg once daily for a urinary tract infection and bacteraemia involving extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. After three ertapenem doses, she developed seizures which self-aborted. Corrected phenytoin level was sub-therapeutic initially, but became therapeutic following a phenytoin dose increase. On Day 14 of ertapenem, the patient suffered another episode of seizure...
December 2015: Drug Saf Case Rep
Jennifer Kirsty Harrison, Azucena Garcia Garrido, Sarah J Rhynas, Gemma Logan, Alasdair M J MacLullich, Juliet MacArthur, Susan Shenkin
BACKGROUND: institutionalisation following acute hospital admission is common and yet poorly described, with policy documents advising against this transition. OBJECTIVE: to characterise the individuals admitted to a care home on discharge from an acute hospital admission and to describe their assessment. DESIGN AND SETTING: a retrospective cohort study of people admitted to a single large Scottish teaching hospital. SUBJECTS: 100 individuals admitted to the acute hospital from home and discharged to a care home...
October 15, 2016: Age and Ageing
Yun Kang, Wendy Moyle, Marie Cooke, Siobhan T O'Dwyer
BACKGROUND: The population is ageing in South Korea, increasing the incidence of dementia and delirium. Despite this, registered nurses in South Korea tend to have poor understanding and limited involvement in the assessment of delirium. AIM: To evaluate the effect of an educational programme on acute care nurses' knowledge, attitudes and the potential for family caregiver involvement in care for older adults with cognitive impairment. METHODS: A mixed-methods study that included a single group, pre-post design and individual interviews was used...
October 11, 2016: Scandinavian Journal of Caring Sciences
C Ruggiero, L Bonamassa, L Pelini, I Prioletta, L Cianferotti, A Metozzi, E Benvenuti, G Brandi, A Guazzini, G C Santoro, P Mecocci, D Black, M L Brandi
: This study investigates the relationship between cognitive dysfunction or delirium detected in the early post-surgical phase and the 1-year mortality among 514 hip fracture hospitalized older persons. Patients with early cognitive dysfunction or delirium experienced a 2-fold increased mortality risk. Early post-operative cognitive dysfunction and delirium are negative prognostic factors for mortality. BACKGROUND AND PURPOSE: Premorbid cognitive impairment and dementia in older individuals negatively affect functional recovery after hip fracture...
October 7, 2016: Osteoporosis International
Leslie S P Eide, Anette H Ranhoff, Bengt Fridlund, Rune Haaverstad, Karl Ove Hufthammer, Karel K J Kuiper, Jan Erik Nordrehaug, Tone M Norekvål
OBJECTIVES: To determine whether postoperative delirium predicts first-time readmissions and mortality in octogenarian patients within 180 days after aortic valve therapy with surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI), and to determine the most common diagnoses at readmission. DESIGN: Prospective cohort study of patients undergoing elective SAVR or TAVI. SETTING: Tertiary university hospital that performs all SAVRs and TAVIs in Western Norway...
October 5, 2016: BMJ Open
Charles H Brown, Andrew LaFlam, Laura Max, Julie Wyrobek, Karin J Neufeld, Khaled M Kebaish, David B Cohen, Jeremy D Walston, Charles W Hogue, Lee H Riley
OBJECTIVES: To characterize the incidence, risk factors, and consequences of delirium in older adults undergoing spine surgery. DESIGN: Prospective observational study. SETTING: Academic medical center. PARTICIPANTS: Individuals aged 70 and older undergoing spine surgery (N = 89). MEASUREMENTS: Postoperative delirium and delirium severity were assessed using validated methods, including the Confusion Assessment Method (CAM), CAM for the Intensive Care Unit, Delirium Rating Scale-Revised-98, and chart review...
October 3, 2016: Journal of the American Geriatrics Society
Katarzyna Mazur, Krzysztof Wilczyński, Jan Szewieczek
BACKGROUND: Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. OBJECTIVE: Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. METHODS: Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward...
2016: Clinical Interventions in Aging
(no author information available yet)
No abstract text is available yet for this article.
October 2016: Critical Care Nurse
Kaitlyn A Gregory
No abstract text is available yet for this article.
October 2016: Critical Care Nurse
Champa Ranasinghe, Aisling Fleury, Nancye M Peel, Ruth E Hubbard
BACKGROUND: A consequence of pressure on hospitals to accommodate care needs of older patients is "boarding" or out-lying from their home ward. This may have greater adverse effects on older inpatients who are frail. METHODS: A retrospective matched cohort study was conducted in an outer metropolitan general hospital. Randomly selected patients hospitalized between July 2012 and June 2013 under the care of an Older Person Evaluation Review and Assessment (OPERA) team (n = 300) were age and sex matched with patients under the care of general physicians (n = 300)...
October 3, 2016: International Psychogeriatrics
Marieke Zegers, Gijs Hesselink, Wytske Geense, Charles Vincent, Hub Wollersheim
OBJECTIVE: To provide an overview of effective interventions aimed at reducing rates of adverse events in hospitals. DESIGN: Systematic review of systematic reviews. DATA SOURCES: PubMed, CINAHL, PsycINFO, the Cochrane Library and EMBASE were searched for systematic reviews published until October 2015. STUDY SELECTION: English-language systematic reviews of interventions aimed at reducing adverse events in hospitals, including studies with an experimental design and reporting adverse event rates, were included...
2016: BMJ Open
Wayne Varndell, Margaret Fry, Doug Elliott
AIM: This systematic review examined the psychometric properties and suitability of the available observational pain instruments for potential use with nonverbal critically ill adult patients in the emergency department. BACKGROUND: In the emergency department assessing pain in critically ill patients is challenging, especially those unable to communicate the presence of pain. Critically ill patients are commonly unable to verbally communicate pain due to altered oral communication (e...
September 29, 2016: Journal of Clinical Nursing
Emily Contrada
No abstract text is available yet for this article.
October 2016: American Journal of Nursing
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