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https://www.readbyqxmd.com/read/29671281/validation-of-caregiver-centered-delirium-detection-tools-a-systematic-review
#1
REVIEW
Brianna Rosgen, Karla Krewulak, Danielle Demiantschuk, E Wesley Ely, Judy E Davidson, Henry T Stelfox, Kirsten M Fiest
OBJECTIVES: To summarize the validity of caregiver-centered delirium detection tools in hospitalized adults and assess associated patient and caregiver outcomes. DESIGN: Systematic review. SETTING: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus from inception to May 15, 2017. PARTICIPANTS: Hospitalized adults. INTERVENTION: Caregiver-centered delirium detection tools. MEASUREMENTS: We drafted a protocol from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
April 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29670988/reducing-complications-and-overall-healthcare-costs-of-hip-fracture-management-a-retrospective-study-on-the-application-of-a-diagnostic-therapeutic-pathway-in-the-cosenza-general-hospital
#2
M Loizzo, F Gallo, D Caruso
BACKGROUND: Diagnostic Therapeutic Pathways (DTPs) are multidisciplinary plans designed by each healthcare organization for a specific category of patients to reduce the variability of professional behaviors and to ensure greater safety and better overall healthcare outcomes. Hip fractures are a frequent traumatic injury, particularly in the elderly, and DTPs recommend early surgical intervention, often not done due to organizational challenges and bureaucracy. Medical conditions suggesting a delay are not frequent, however long waiting times not only increase the risk of complications and mortality, but also increase the number of diagnostic test and physician consultations...
May 2018: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/29650886/-usefulness-of-suvorexant-for-complicated-delirium-in-cancer-patients-who-experience-sleep-disturbance-during-hospitalization
#3
Takaomi Kessoku, Akihiko Kusakabe, Tetsuya Matsuura, Yasushi Honda, Asuka Yoshimi, Ayumu Goto, Haruhisa Yoshida, Akiko Sukegawa, Chiaki Hata, Yukie Saito, Yoko Miyashita, Ryoko Yashiro, Tomoya Komori, Sachiko Arai, Atsushi Nakajima, Yasushi Ichikawa
We investigated the usefulness of suvorexant for complicated delirium in patients with cancer who experience sleep disturbance during hospitalization. Nine patients with malignant tumors complicated with symptoms of delirium and insomnia were included in this study; their palliative care was managed by the palliative care team of our hospital for a period of one year from April 2016 to March 2017. A retrospective follow-up study was then conducted. The Japanese version of DRS-R98 was used to evaluate the severity of the patient's delirium...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650354/risk-factors-for-postoperative-delirium-in-patients-undergoing-free-flap-reconstruction-for-oral-cancer
#4
T Makiguchi, S Yokoo, J Kurihara
The aim of this study was to investigate risk factors for postoperative delirium in patients undergoing free flap reconstruction for defects after oral cancer resection. This was a non-randomized, retrospective cohort study involving 102 patients who underwent oral cancer resection and free flap reconstruction. Data were collected from the medical records. Postoperative delirium occurred in 34 patients (33.3%), of whom 27 were male and seven were female. High preoperative total protein and albumin, diabetes mellitus, history of smoking, use of hypnotics or antipsychotics, time until getting out of bed after surgery, and postoperative insomnia were significantly related to delirium in the univariate analysis (P<0...
April 10, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29644400/-erratum-to-hot-topic-management-of-delirium
#5
(no author information available yet)
No abstract text is available yet for this article.
April 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29623160/geriatric-basics-for-the-neurohospitalist
#6
REVIEW
Josef G Heckmann, Jörg Kraus, Christoph J G Lang
Due to the increasing age of the population, neurohospitalists are more frequently caring for old and very old people. Fundamental definitions and topics related to geriatric medicine are therefore of particular importance. In this review, common issues encountered in geriatric patients hospitalized on the neurology service are discussed. Focus is put on the geriatric assessment, multiprofessional diagnostic and therapeutic procedures, geriatric syndromes, pharmacotherapy of the aged, delirium, pain, and palliative management as they are relevant for the neurohospitalist...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29615969/postoperative-delirium-learning-and-anesthetic-neurotoxicity-some-perspectives-and-directions
#7
W Alan C Mutch, Renée M El-Gabalawy, M Ruth Graham
Evidence of anesthetic neurotoxicity is unequivocal when studied in animal models. These findings have translated poorly to the clinical domain when equated to postoperative delirium (POD) in adults and postoperative cognitive dysfunction (POCD) in either children or the elderly. In this perspective, we examine various reasons for the differences between animal modeling of neurotoxicity and the clinical situation of POD and POCD and make suggestions as to potential directions for ongoing research. We hypothesize that the animal anesthetic neurotoxicity models are limited, in part, due to failed scaling correction of physiological time...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29610916/should-this-patient-receive-prophylactic-medication-to-prevent-delirium-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#8
Anjala V Tess, Melissa L P Mattison, Joshua R Leo, Eileen E Reynolds
In 2015, the American Geriatrics Society released recommendations for prevention and management of postoperative delirium, based on a systematic literature review and evaluation of nonpharmacologic and pharmacologic approaches by an expert panel. The guidelines recommend an interdisciplinary focus on nonpharmacologic measures (reorientation, medication management, early mobility, nutrition, and gastointestinal motility) for prevention and consideration of this strategy for acute management. They also recommend optimizing nonopioid medication as a means to manage pain and avoiding benzodiazepines other than to treat substance withdrawal...
April 3, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29609624/can-education-improve-clinical-practice-concerning-delirium-in-older-hospitalised-patients-results-of-a-pre-test-post-test-study-on-an-educational-intervention-for-nursing-staff
#9
Eveline L van Velthuijsen, Sandra M G Zwakhalen, Ron M J Warnier, Ton Ambergen, Wubbo J Mulder, Frans R J Verhey, Gertrudis I J M Kempen
BACKGROUND: Delirium is a common and serious complication of hospitalisation in older adults. It can lead to prolonged hospital stay, institutionalisation, and even death. However, it often remains unrecognised or is not managed adequately. The aim of this study was to evaluate the effects of an educational intervention for nursing staff on three aspects of clinical practice concerning delirium in older hospitalised patients: the frequency and correctness of screening for delirium using the 13-item Delirium Observation Screening score (DOS), and the frequency of geriatric consultations requested for older patients...
April 2, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29580965/designing-a-nurse-delivered-delirium-bundle-what-intensive-care-unit-staff-survivors-and-their-families-think
#10
Leona Bannon, Jennifer McGaughey, Mike Clarke, Daniel F McAuley, Bronagh Blackwood
BACKGROUND: Implementation of quality improvement interventions can be enhanced by exploring the perspectives of those who will deliver and receive them. We designed a non-pharmacological bundle for delirium management for a feasibility trial, and we sought to obtain the views of intensive care unit (ICU) staff, survivors, and families on the barriers and facilitators to its implementation. OBJECTIVE: The objective of this study is to determine the barriers and facilitators to a multicomponent bundle for delirium management in critically ill patients comprising (1) education and family participation, (2) sedation minimisation and pain, agitation, and delirium protocol, (3) early mobilisation, and (4) environmental interventions for sleep, orientation, communication, and cognitive stimulation...
March 23, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29571595/-sedation-is-tricky-a-qualitative-content-analysis-of-nurses-perceptions-of-sedation-administration-in-mechanically-ventilated-intensive-care-unit-patients
#11
Breanna Hetland, Jill Guttormson, Mary Fran Tracy, Linda Chlan
INTRODUCTION: Critical care nurses are responsible for administering sedative medications to mechanically ventilated patients. With significant advancements in the understanding of the impact of sedative exposure on physiological and psychological outcomes of ventilated patients, updated practice guidelines for assessment and management of pain, agitation, and delirium in the intensive care unit were released in 2013. The primary aim of this qualitative study was to identify and describe themes derived from critical care nurses' comments regarding sedation administration practices with mechanically ventilated patients...
March 20, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29559010/association-of-joint-replacement-surgery-with-incident-dementia-diagnosis-in-german-claims-data
#12
Stefan J Teipel, Thomas Fritze, Martin Ellenrieder, Britta Haenisch, Wolfram Mittelmeier, Gabriele Doblhammer
BACKGROUND: Cognitive decline is an important complication of joint replacement surgeries in senior people. METHODS: We determined incidence rates of dementia diagnosis following endoprosthetic joint replacement surgery (upper and lower extremities). The observation period covered up to 28 quarters using German claims data comprising 154,604 cases 65 years and older. Effects were controlled for cerebrovascular and vascular risk factors, age, sex, the presence of a diagnosis of delirium, and regular prescription of sedative or analgesic drugs (SAD)...
March 21, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29549210/quality-indicators-for-in-hospital-geriatric-co-management-programmes-a-systematic-literature-review-and-international-delphi-study
#13
Bastiaan Van Grootven, Lynn McNicoll, Daniel A Mendelson, Susan M Friedman, Katleen Fagard, Koen Milisen, Johan Flamaing, Mieke Deschodt
OBJECTIVE: To find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes. DESIGN: An international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers). SETTING: Western Europe and the USA. PARTICIPANTS: Thirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited...
March 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29543606/ce-original-research-recognizing-delirium-in-hospitalized-children-a-systematic-review-of-the-evidence-on-risk-factors-and-characteristics
#14
Cheryl Holly, Sallie Porter, Mercedes Echevarria, Margaret Dreker, Sevara Ruzehaji
The findings can facilitate earlier recognition and prevention of pediatric delirium. ABSTRACT: Purpose: The purpose of this study was to examine the evidence regarding the risk factors for and characteristics of acute pediatric delirium in hospitalized children. METHODS: The systematic review method within an epidemiological framework of person, place, and time was used. Fifty-two studies were selected for initial retrieval. Of these, after assessment for methodological quality, 21 studies involving 2,616 subjects were included in the review...
March 14, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29535468/clinical-practice-guidelines-for-management-of-delirium-in-elderly
#15
Sandeep Grover, Ajit Avasthi
No abstract text is available yet for this article.
February 2018: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/29532465/voluntary-stopping-eating-and-drinking
#16
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29530688/risk-factors-for-postoperative-delirium-after-deep-brain-stimulation-surgery-for-parkinson-s-disease
#17
Masataka Tanaka, Naoki Tani, Tomoyuki Maruo, Satoru Oshino, Koichi Hosomi, Youichi Saitoh, Haruhiko Kishima
OBJECTIVE: The aim of this study was to investigate the incidence of and risk factors for postoperative delirium (POD) after deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). METHODS: We analyzed the preoperative T1-weigthed magnetic resonance imaging data of 71 PD patients who underwent DBS surgery. Multiple regression analysis was done with age, l-dopa equivalent daily dose, laterality of the surgery, target regions, number of electrode trajectories tried, grey matter (GM) volume, and white matter (WM) volume as explanatory variables and the duration (number of days) of POD as the response variable...
March 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29528895/use-of-psychotropic-medication-in-women-with-psychotic-disorders-at-menopause-and-beyond
#18
Mary V Seeman, Alexandre González-Rodríguez
PURPOSE OF REVIEW: Drugs have been extensively prescribed for the treatment of psychotic symptoms in schizophrenia and related disorders, as well as for the management of psychotic features in delirium, dementia and affective disorders. The aim of this narrative review is to focus on the recent literature on drug treatment in women with psychosis at the transition to menopause and subsequently. RECENT FINDINGS: The recent literature emphasizes the following points: the efficacy of antipsychotic medication in psychosis is largely confined to the alleviation of delusions and hallucinations; menopause and ageing alter the kinetics and dynamics of drug action; drugs other than antipsychotics are currently being tested to address the cognitive, affective and negative symptoms of psychotic illnesses; menopausal symptoms add to comorbidities and require simultaneous treatment, raising the probability of deleterious drug interactions; antipsychotic drugs have many side effects and contribute to high mortality rates in the older psychosis population...
March 9, 2018: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/29523558/drug-associated-risk-tool-development-and-validation-of-a-self-assessment-questionnaire-to-screen-for-hospitalised-patients-at-risk-for-drug-related-problems
#19
Carole P Kaufmann, Dominik Stämpfli, Nadine Mory, Kurt E Hersberger, Markus L Lampert
INTRODUCTION: Identifying patients with a high risk for drug-related problems (DRPs) might optimise the allocation of targeted pharmaceutical care during the hospital stay and on discharge. OBJECTIVE: To develop a self-assessment screening tool to identify patients at risk for DRPs and validate the tool regarding feasibility, acceptability and the reliability of the patients' answers. DESIGN: Prospective validation study. SETTING: Two mid-sized hospitals (300-400 beds)...
March 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29521857/effectiveness-of-non-pharmacological-strategies-for-managing-delirium-in-hospitalized-postoperative-adults-an-umbrella-review-protocol
#20
Joan McNeil, Anne Marie Denis, Urick Michel, Catherine M Concert
The question of this review: What is the effectiveness of non-pharmacological strategies for the management of delirium in hospitalized adult postoperative patients?The objective of this umbrella review is to determine the effectiveness of non-pharmacological strategies for the management of delirium in adult postoperative patients, 18 years and over, in an acute care hospitalized setting.More specifically, the review aims to identify which non-pharmacological strategy/strategies, provided as a single strategy or combined as two or more strategies, is the most effective for management of delirium in hospitalized postoperative adult patients?...
March 2018: JBI Database of Systematic Reviews and Implementation Reports
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