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Delirium screening

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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
#1
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/28079605/delirium-in-critically-ill-children-an-international-point-prevalence-study
#2
Chani Traube, Gabrielle Silver, Ron W Reeder, Hannah Doyle, Emily Hegel, Heather A Wolfe, Christopher Schneller, Melissa G Chung, Leslie A Dervan, Jane L DiGennaro, Sandra D W Buttram, Sapna R Kudchadkar, Kate Madden, Mary E Hartman, Mary L deAlmeida, Karen Walson, Erwin Ista, Manuel A Baarslag, Rosanne Salonia, John Beca, Debbie Long, Yu Kawai, Ira M Cheifetz, Javier Gelvez, Edward J Truemper, Rebecca L Smith, Megan E Peters, A M Iqbal O'Meara, Sarah Murphy, Abdulmohsen Bokhary, Bruce M Greenwald, Michael J Bell
OBJECTIVES: To determine prevalence of delirium in critically ill children and explore associated risk factors. DESIGN: Multi-institutional point prevalence study. SETTING: Twenty-five pediatric critical care units in the United States, the Netherlands, New Zealand, Australia, and Saudi Arabia. PATIENTS: All children admitted to the pediatric critical care units on designated study days (n = 994). INTERVENTION: Children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the bedside nurse...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28077196/brief-assessment-of-delirium-subtypes-psychometric-evaluation-of-the-delirium-motor-subtype-scale-dmss-4-in-the-intensive-care-setting
#3
Soenke Boettger, David Garcia Nuñez, Rafael Meyer, Andre Richter, Maria Schubert, David Meagher, Josef Jenewein
OBJECTIVE: The management of and prognosis for delirium are affected by its subtype: hypoactive, hyperactive, mixed, and none. The DMSS-4, an abbreviated version of the Delirium Motor Symptom Scale, is a brief instrument for the assessment of delirium subtypes. However, it has not yet been evaluated in an intensive care setting. METHOD: We performed a prospective/descriptive cohort study in order to determine the internal consistency, reliability, and validity of the relevant items of the DMSS-4 versus the Delirium Rating Scale-Revised-98 (DRS-R-98) and the original DMSS in a surgical intensive care setting...
January 12, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28058496/-traumatology-in-the-elderly-multimodal-prevention-of-delirium-and-use-of-augmentation-techniques
#4
D Wähnert, A Roos, J Glasbrenner, K Ilting-Reuke, P Ohrmann, G Hempel, T Duning, N Roeder, M J Raschke
Recent data show that 20-80% of surgery patients are affected by delirium during inpatient clinical treatment. The medical consequences are often dramatic and include a 20 times higher mortality and treatment expenses of the medical unit increase considerably. At the University Hospital of Münster a multimodal and interdisciplinary concept for prevention and management of delirium was developed: all patients older than 65 years admitted for surgery are screened by a specialized team for the risk of developing delirium and treated by members of the team if there is a risk of delirium...
January 5, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28055085/delirium-update-for-postacute-care-and-long-term-care-settings-a-narrative-review
#5
Martin M Forsberg
Advances have been made in our understanding of the neuropathogenesis, recognition, and strategies for reducing the incidence of delirium in acute-care settings. However, relatively little attention has been given to delirium in elderly patients in the postacute care (PAC) and long-term care (LTC) settings. The present article reviews the most relevant current research pertaining to this population. Hospital patients with delirium are often discharged to PAC settings. Delirium that develops in the LTC setting is often more insidious and subtle in presentation...
January 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/28041617/-postoperative-surveillance-in-neurosurgical-patients-usefulness-of-neurological-assessment-scores-and-bispectral-index
#6
Silvia Herrero, Enrique Carrero, Ricard Valero, Jose Rios, Neus Fábregas
BACKGROUND AND OBJECTIVES: We examined the additive effect of the Ramsay scale, Canadian Neurological Scale (CNS), Nursing Delirium Screening Scale (Nu-DESC), and Bispectral Index (BIS) to see whether along with the assessment of pupils and Glasgow Coma Scale (GCS) it improved early detection of postoperative neurological complications. METHODS: We designed a prospective observational study of two elective neurosurgery groups of patients: craniotomies (CG) and non-craniotomies (NCG)...
December 29, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28024558/detection-prevention-and-management-of-delirium-in-the-critically-ill-cardiac-patient-and-patients-who-undergo-cardiac-procedures
#7
REVIEW
Rakesh C Arora, George Djaiani, James L Rudolph
Delirium is an acute change in cognitive functioning, characterized by inattention and associated with alterations in awareness and fluctuation in arousal, disorganized thinking, or altered level that preferentially affects older adult patients. In the acutely ill cardiac patient, the incidence of delirium has been reported as high as 73%, depending on the type and sensitivity of delirium assessment. Cardiac patients with delirium experience higher rates of in-hospital and longer-term mortality and are at risk for progressive cognitive impairment, loss of functional independence, and increased hospitalization costs...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28008258/incidence-risk-factors-and-phenomenological-characteristics-of-postoperative-delirium-in-patients-receiving-intravenous-patient-controlled-analgesia-a-prospective-cohort-study
#8
Yao Tsung Lin, Kuo Mao Lan, Li-Kai Wang, Chin-Chen Chu, Su-Zhen Wu, Chia-Yu Chang, Jen-Yin Chen
BACKGROUND: Intravenous patient-controlled analgesia (IVPCA) is a common method of relieving pain which is a risk factor of postoperative delirium (POD). However, research concerning POD in IVPCA patients is limited. OBJECTIVE: We aimed to determine the incidence, risk factors, and phenomenological characteristics of POD in patients receiving IVPCA. METHODS: A prospective, cohort study was conducted in post-general anesthesia IVPCA patients aged ≥60 years...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27998325/improving-the-care-of-people-with-dementia-in-general-hospitals-evaluation-of-a-whole-system-train-the-trainer-model
#9
Elizabeth L Sampson, Victoria Vickerstaff, Stephanie Lietz, Martin Orrell
BACKGROUND: There are concerns about the quality of care that people with dementia receive in the general hospital. Staff report a lack of confidence and inadequate training in dementia care. METHODS: A train-the-trainer model was implemented across eight acute hospital trusts in London via a large academic health and science network. Impact was evaluated using mixed methods. Data were collected at (a) individual level: "Sense of Competence in Dementia Care" (SCID), (b) ward level: Person Interaction and Environment (PIE) observations, (c) organization level: use of specific tools, i...
December 21, 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27984255/knowns-and-unknowns-about-delirium-in-stroke-a-review
#10
Elzbieta Klimiec, Tomasz Dziedzic, Katarzyna Kowalska, Agnieszka Slowik, Aleksandra Klimkowicz-Mrowiec
Delirium is a transient condition characterized by sudden and fluctuating disturbances in cognitive function. The condition can be considered a sign of the brain's vulnerability and diminished resilience to insult. Among the many clinical manifestations are cognitive, psychomotor, and sleep disturbances. Delirium is associated with longer hospital stays, worse functional outcomes, and higher mortality. Although up to 48% of patients who have had a stroke develop delirium, the condition has been studied much less in these patients than in general medicine, surgical, and intensive care patients...
December 2016: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/27977539/delirium-in-children-after-cardiac-bypass-surgery
#11
Anita K Patel, Katherine V Biagas, Eunice C Clarke, Linda M Gerber, Elizabeth Mauer, Gabrielle Silver, Paul Chai, Rozelle Corda, Chani Traube
OBJECTIVES: To describe the incidence of delirium in pediatric patients after cardiac bypass surgery and explore associated risk factors and effect of delirium on in-hospital outcomes. DESIGN: Prospective observational single-center study. SETTING: Fourteen-bed pediatric cardiothoracic ICU. PATIENTS: One hundred ninety-four consecutive admissions following cardiac bypass surgery, 1 day to 21 years old. INTERVENTIONS: Subjects were screened for delirium daily using the Cornell Assessment of Pediatric Delirium...
December 13, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27936113/preoperative-csf-melatonin-concentrations-and-the-occurrence-of-delirium-in-older-hip-fracture-patients-a-preliminary-study
#12
Rikie M Scholtens, Sophia E J A de Rooij, Annelies E Vellekoop, Bart C Vrouenraets, Barbara C van Munster
BACKGROUND: Delirium is characterized by disturbances in circadian rhythm. Melatonin regulates our circadian rhythm. Our aim was to compare preoperative cerebrospinal fluid (CSF) melatonin levels in patients with and without postoperative delirium. METHODS: Prospective cohort study with hip fracture patients ≥ 65 years who were acutely admitted to the hospital for surgical treatment and received spinal anaesthesia. CSF was collected after cannulation, before administering anaesthetics...
2016: PloS One
https://www.readbyqxmd.com/read/27922747/frailty-and-subsequent-disability-and-mortality-among-patients-with-critical-illness
#13
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/27918778/efficacy-of-oral-risperidone-haloperidol-or-placebo-for-symptoms-of-delirium-among-patients-in-palliative-care-a-randomized-clinical-trial
#14
Meera R Agar, Peter G Lawlor, Stephen Quinn, Brian Draper, Gideon A Caplan, Debra Rowett, Christine Sanderson, Janet Hardy, Brian Le, Simon Eckermann, Nicola McCaffrey, Linda Devilee, Belinda Fazekas, Mark Hill, David C Currow
Importance: Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. Objective: To determine efficacy of risperidone or haloperidol relative to placebo in relieving target symptoms of delirium associated with distress among patients receiving palliative care. Design, Setting, and Participants: A double-blind, parallel-arm, dose-titrated randomized clinical trial was conducted at 11 Australian inpatient hospice or hospital palliative care services between August 13, 2008, and April 2, 2014, among participants with life-limiting illness, delirium, and a delirium symptoms score (sum of Nursing Delirium Screening Scale behavioral, communication, and perceptual items) of 1 or more...
January 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27917538/five-short-screening-tests-in-the-detection-of-prevalent-delirium-diagnostic-accuracy-and-performance-in-different-neurocognitive-subgroups
#15
N A O'Regan, K Maughan, N Liddy, J Fitzgerald, D Adamis, D W Molloy, D Meagher, S Timmons
BACKGROUND: Delirium is prevalent and serious, yet remains under-recognised. Systematic screening could improve detection; however, consensus is lacking as to the best approach. Our aim was to assess the diagnostic accuracy of five simple cognitive tests in delirium screening: six-item cognitive impairment test (6-CIT), clock-drawing test, spatial span forwards, months of the year backwards (MOTYB) and intersecting pentagons (IPT). METHODS: A cross-sectional study was conducted...
December 5, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27902744/delirium-detection-and-impact-of-comorbid-health-conditions-in-a-post-acute-rehabilitation-hospital-setting
#16
Julija Stelmokas, Nicolette Gabel, Jennifer M Flaherty, Katherine Rayson, Kathileen Tran, Jason R Anderson, Linas A Bieliauskas
Misdiagnosis and under-detection of delirium may occur in many medical settings. This is important to address as delirium clearly increases risk of morbidity and mortality in such settings. This study assessed whether Veterans who screened positive on a delirium severity measure (Memorial Delirium Assessment Scale; MDAS) differed from those with and without corresponding medical documentation of delirium in terms of cognitive functioning, psychiatric/medical history, and medication use. A medical record review of 266 inpatients at a VA post-acute rehabilitation unit found that 10...
2016: PloS One
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
#17
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/27893697/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#18
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)
https://www.readbyqxmd.com/read/27881185/melatonin-and-melatonin-agonists-to-prevent-and-treat-delirium-in-critical-illness-a-systematic-review-protocol
#19
Jennifer Foster, Lisa D Burry, Lehana Thabane, Karen Choong, Kusum Menon, Mark Duffett, Alexandra Cheung, Melanie Guenette, Timothy Chimunda, Louise Rose
BACKGROUND: Delirium is a syndrome characterized by acute fluctuations and alterations in attention and arousal. Critically ill patients are at particularly high risk, and those that develop delirium are more likely to experience poor clinical outcomes such as prolonged duration of ICU and hospital length of stay, and increased mortality. Melatonin and melatonin agonists (MMA) have the potential to decrease the incidence and severity of delirium through their hypnotic and sedative-sparing effects, thus improving health-related outcomes...
November 24, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27879983/delirium-a-survey-of-healthcare-professionals-knowledge-beliefs-and-practices
#20
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
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