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Delirium intervention

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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
#1
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/28096011/a-systematic-nurse-led-approach-to-withdrawal-risk-screening-prevention-and-treatment-among-inpatients-with-an-alcohol-use-disorder-in-an-ear-nose-throat-and-jaw-surgery-department-a-formative-evaluation
#2
Deborah Linda Leuenberger, Katharina Fierz, Andreas Hinck, Daniel Bodmer, Wolfgang Hasemann
INTRODUCTION: Among patients with head and neck cancer comorbid alcohol use disorder is frequent which contributes to higher risk of developing perioperative alcohol withdrawal syndrome/delirium or delirium due to medical conditions. Although guidelines emphasize prevention and treatment of alcohol withdrawal in hospitalized patients, a validated systematic approach for management of these patients is still lacking. Our aim was to formatively evaluate our newly developed systematic approach in view of nurses' adherence to screening patients for regular alcohol consumption and managing their withdrawal symptoms using the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised...
February 2017: Applied Nursing Research: ANR
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
#3
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/28087236/determination-of-the-feasibility-of-a-multicomponent-intervention-program-to-prevent-delirium-in-the-intensive-care-unit-a-modified-rand-delphi-study
#4
Annelies Wassenaar, Mark van den Boogaard, Underpin-Icu Study Group, Lisette Schoonhoven, Peter Pickkers
BACKGROUND: Delirium is common in Intensive Care Unit (ICU) patients and associated with poor outcome. In non-ICU patients a multicomponent intervention program with non-pharmacological interventions has shown to reduce delirium. Currently, there is insufficient evidence regarding the effects of such a program in ICU patients. We developed a draft program based on a review. As most studies were conducted in non-ICU patients, the feasibility of the program in ICU patients needs to be assessed before investigating its effectiveness...
January 10, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28068906/cherish-collaboration-for-hospitalised-elders-reducing-the-impact-of-stays-in-hospital-protocol-for-a-multi-site-improvement-program-to-reduce-geriatric-syndromes-in-older-inpatients
#5
Alison M Mudge, Merrilyn D Banks, Adrian G Barnett, Irene Blackberry, Nicholas Graves, Theresa Green, Gillian Harvey, Ruth E Hubbard, Sharon K Inouye, Sue Kurrle, Kwang Lim, Prue McRae, Nancye M Peel, Jessica Suna, Adrienne M Young
BACKGROUND: Older inpatients are at risk of hospital-associated geriatric syndromes including delirium, functional decline, incontinence, falls and pressure injuries. These contribute to longer hospital stays, loss of independence, and death. Effective interventions to reduce geriatric syndromes remain poorly implemented due to their complexity, and require an organised approach to change care practices and systems. Eat Walk Engage is a complex multi-component intervention with structured implementation, which has shown reduced geriatric syndromes and length of stay in pilot studies at one hospital...
January 9, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28068834/design-considerations-of-a-randomized-controlled-trial-of-sedation-level-during-hip-fracture-repair-surgery-a-strategy-to-reduce-the-incidence-of-postoperative-delirium-in-elderly-patients
#6
Tianjing Li, L Susan Wieland, Esther Oh, Karin J Neufeld, Nae-Yuh Wang, Kay Dickersin, Frederick E Sieber
Background Delirium is an acute change in mental status characterized by sudden onset, fluctuating course, inattention, disorganized thinking, and abnormal level of consciousness. The objective of the randomized controlled trial "A STrategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" (STRIDE) is to assess the effectiveness of light versus heavy sedation on delirium and other outcomes in elderly patients undergoing hip fracture repair surgery. Our goal is to describe the design considerations and lessons learned in planning and implementing the STRIDE trial...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28049548/chimeric-antigen-receptor-t-cell-neuropsychiatric-toxicity-in-acute-lymphoblastic-leukemia
#7
Vasthie Prudent, William S Breitbart
Chimeric antigen receptor T cells are used in the treatment of B-cell leukemias. Common chimeric antigen receptor T-cell toxicities can range from mild flu-like symptoms, such as fever and myalgia, to a more striking neuropsychiatric toxicity that can present as discrete neurological symptoms and delirium. We report here two cases of chimeric antigen receptor T-cell neuropsychiatric toxicity, one who presented as a mild delirium and aphasia that resolved without intervention, and one who presented with delirium, seizures, and respiratory insufficiency requiring intensive treatment...
January 4, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28039852/pathway-from-delirium-to-death-potential-in-hospital-mediators-of-excess-mortality
#8
Kumar Dharmarajan, Sunil Swami, Ray Y Gou, Richard N Jones, Sharon K Inouye
OBJECTIVES: (1) To determine the relationship of incident delirium during hospitalization with 90-day mortality; (2) to identify potential in-hospital mediators through which delirium increases 90-day mortality. DESIGN: Analysis of data from Project Recovery, a controlled clinical trial of a delirium prevention intervention from 1995 to 1998 with follow-up through 2000. SETTING: Large academic hospital. PARTICIPANTS: Patients ≥70 years old without delirium at hospital admission who were at intermediate-to-high risk of developing delirium and received usual care only...
December 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28013104/the-impact-of-nursing-delirium-preventive-innterventions-in-the-intensive-care-unit-underpin-icu-a-study-protocol-for-a-multi-centre-stepped-wedge-randomized-controlled-trial
#9
Annelies Wassenaar, Paul Rood, Lisette Schoonhoven, Steven Teerenstra, Marieke Zegers, Peter Pickkers, Mark van den Boogaard
BACKGROUND: Delirium is a common disorder in Intensive Care Unit (ICU) patients and is associated with serious short- and long-term consequences, including re-intubations, ICU readmissions, prolonged ICU and hospital stay, persistent cognitive problems, and higher mortality rates. Considering the high incidence of delirium and its consequences, prevention of delirium is imperative. This study focuses on a program of standardized nursing and physical therapy interventions to prevent delirium in the ICU, called UNDERPIN-ICU (nUrsiNg DEliRium Preventive INterventions in the ICU)...
December 8, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27998370/understanding-delirium-trajectory-and-its-importance-in-care-provision-for-older-people
#10
Guk-Hee Suh, Lina Gega
Delirium significantly increases morbidity and mortality in older people, especially those affected by other organic disorders, notably dementia (Siddiqi et al., 2006; Davis et al., 2012; Martins and Fernandes, 2012). Both delirium and dementia are characterized by cognitive decline through disintegration of brain functions, i.e. a "brain failure." Delirium has been described as an acute brain failure, in contrast to dementia being a chronic brain failure (Berrios, 1981). If we consider any other organ failure, for example that of kidneys, delirium superimposed on dementia resembles acute renal exacerbation superimposed on chronic renal failure...
January 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/27977439/bilateral-sternal-infusion-of-ropivacaine-and-length-of-stay-in-icu-after-cardiac-surgery-with-increased-respiratory-risk-a-randomised-controlled-trial
#11
Vedat Eljezi, Etienne Imhoff, Daniel Bourdeaux, Bruno Pereira, Mehdi Farhat, Pierre Schoeffler, Kasra Azarnoush, Christian Dualé
BACKGROUND: The continuous bilateral infusion of a local anaesthetic solution around the sternotomy wound (bilateral sternal) is an innovative technique for reducing pain after sternotomy. OBJECTIVE: To assess the effects of the technique on the need for intensive care in cardiac patients at increased risk of respiratory complications. DESIGN: Randomised, observer-blind controlled trial. SETTING: Single centre, French University Hospital...
February 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27965224/feasibility-and-effectiveness-of-a-delirium-prevention-bundle-in-critically-ill-patients
#12
Claudia DiSabatino Smith, Petra Grami
BACKGROUND: Strategies for preventing delirium include early identification and avoiding or modifying patient, environmental, and iatrogenic factors. Minimal research exists on a prescriptive delirium prevention bundle that details elements or strategies for each bundle component. Even less research has been focused on nurse-driven interventions or components. OBJECTIVE: To evaluate the effectiveness of a delirium prevention bundle in decreasing delirium incidence in 2 medical-surgical intensive care units in a large Texas medical center...
December 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27956074/aide-acute-illness-and-depression-in-elderly-patients-cognitive-behavioral-group-psychotherapy-in-geriatric-patients-with-comorbid-depression-a-randomized-controlled-trial
#13
Jana Hummel, Cecilia Weisbrod, Leila Boesch, Katharina Himpler, Klaus Hauer, Martin Hautzinger, Andrea Gaebel, Tania Zieschang, Andrea Fickelscherer, Slawomira Diener, Ilona Dutzi, Bertram Krumm, Peter Oster, Daniel Kopf
BACKGROUND: Comorbid depression is highly prevalent in geriatric patients and associated with functional loss, frequent hospital re-admissions, and a higher mortality rate. Cognitive behavioral psychotherapy (CBT) has shown to be effective in older depressive patients living in the community. To date, CBT has not been applied to older patients with acute physical illness and comorbid depression. OBJECTIVES: To evaluate the effectiveness of CBT in depressed geriatric patients, hospitalized for acute somatic illness...
December 9, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27934642/demdel-a-nursing-led-practice-based-delirium-intervention-improves-certain-outcomes-for-older-cognitively-impaired-inpatients
#14
Anne P F Wand, Andrew Teodorczuk
No abstract text is available yet for this article.
January 2017: Evidence-based Nursing
https://www.readbyqxmd.com/read/27927732/trauma-informed-hospice-and-palliative-care
#15
Barbara L Ganzel
This review highlights the need to integrate trauma-informed practices into hospice and palliative care. The pervasiveness of psychological trauma exposure has been established in the general population and among the elderly adults. Moreover, there is emerging evidence for multiple additional opportunities for exposure to psychological trauma at or near the end of life. For example, many people experience intensive medical interventions prior to their admission to hospice and/or palliative care, and there is increasing recognition that these interventions may be traumatic...
December 7, 2016: Gerontologist
https://www.readbyqxmd.com/read/27923397/pharmacological-interventions-for-delirium-in-intensive-care-patients-a-protocol-for-an-overview-of-reviews
#16
Marija Barbateskovic, Laura Krone Larsen, Marie Oxenbøll-Collet, Janus Christian Jakobsen, Anders Perner, Jørn Wetterslev
BACKGROUND: The prevalence of delirium in intensive care unit (ICU) patients is high. Delirium has been associated with morbidity and mortality including more ventilator days, longer ICU stay, increased long-term mortality and cognitive impairment. Thus, the burden of delirium for patients, relatives and societies is considerable. Today, reviews of randomised clinical trials are produced in large scales sometimes making it difficult to get an overview of the available evidence. A preliminary search identified several reviews investigating the effects of pharmacological interventions for the management and prevention of delirium in ICU patients...
December 7, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27922747/frailty-and-subsequent-disability-and-mortality-among-patients-with-critical-illness
#17
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
#18
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/27899718/postoperative-delirium-after-liver-transplantation-is-associated-with-increased-length-of-stay-and-lower-survival-in-a-prospective-cohort
#19
Sonja Beckmann, Maria Schubert, Hanna Burkhalter, Philipp Dutkowski, Sabina De Geest
INTRODUCTION: Although postoperative delirium (POD) is a common in-hospital complication associated with negative outcomes, evidence in liver transplantation (LT) is scarce. OBJECTIVE: We examined the incidence and duration of POD, its impact on outcomes and health-care utilization, and described predisposing and precipitating factors favoring POD development. DESIGN: This prospective cohort study included adults undergoing transplantation in a tertiary hospital...
November 28, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27874185/translating-delirium-prevention-strategies-for-elderly-adults-with-hip-fracture-into-routine-clinical-care-a-pragmatic-clinical-trial
#20
Susan Freter, Katalin Koller, Michael Dunbar, Chris MacKnight, Kenneth Rockwood
OBJECTIVES: To compare the feasibility (adherence) and effectiveness (prevalence of delirium, length of stay, mortality, discharge site) of delirium-friendly preprinted postoperative orders (PPOs) for individuals with hip fracture, administered by regular orthopedic nurses, with routine postoperative orders. DESIGN: Pragmatic clinical trial to evaluate a quality improvement intervention. SETTING: Tertiary care hospital. PARTICIPANTS: Individuals aged 65 and older admitted for hip fracture repair (N = 283)...
November 22, 2016: Journal of the American Geriatrics Society
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