Delirium Screening Tool Found Effective for Nurse Assessment of Delirium in Surgical Patients
Delirium is common but often under-recognized.
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Early recognition of the risk factors and signs of delirium can help minimize the occurrence and duration of episodes, according to poster presented at the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference.
Although delirium is a common medical problem, it is under-recognized and leads to worse outcomes such as functional decline, increased morbidity and mortality, greater likelihood of nursing home placement, longer lengths of stay, and higher healthcare costs. The American Psychiatric Association notes that delirium affects 51% of postoperative patients and 10% to 40% of hospitalized patients.
For this study, nurses completed surveys to assess their knowledge regarding the Confusion Assessment Method (CAM) screening tool. Nurses on an oncology medical/surgical unit underwent training the use of the CAM tool, recognition of delirium, and interventions for managing delirium in the older adult at in-services and assigned online education.
The goal was to improve recognition of delirium in adult patients aged 65 and older who had undergone urologic surgery and to implement a delirium protocol as appropriate. The protocol involved initiation and documentation of the CAM screening tool, initiation of a delirium prevention protocol, and use of delirium order sets.
The pilot was conducted from June 2017 until November 2017, with anticipated results showing improved use of the CAM screening tool, delirium protocol, and use of delirium order sets. Preliminary data shows the protocol was implemented on patients hospitalized for urologic and other types of surgery.
The authors conclude that “nurses are in a key position to recognize risk factors and signs of delirium, and can assess their patients and intervene early to minimize the occurrence and duration of delirium. To date, the recognition of delirium in other postoperative surgical patients has also improved.”
Uranga C, Chien L. Delirium prevention in hospitalized urology cancer patients 65 and older: a pilot project. Poster presentation at: NACNS 2018 Annual Conference; February 28-March 3, 2018; Austin, TX.