Acute confusion indicators: Risk factors and prevalence using MDS data

Abstract

Long-term care (LTC) Minimum Data Set (MDS) data from a Midwestern state were analyzed to validate whether components of a conceptual model developed from findings in acute care identified acute confusion risk variables in LTC. The prevalence of probable acute confusion in this sample was 13.98% (n = 324). Using a cross-sectional design, both univariate and unconditional stepwise logistic regression analyses were accomplished with presence or absence of probable acute confusion as the outcome variable (N = 2,318). Variables significantly related to acute confusion by univariate analysis were included in the logistic regression analysis. Inadequate fluid intake was the first variable to enter the stepwise equation and was highly significant (OR 3.40, 95% CI 2.99-3.81, p < .0001). Other significant variables included a diagnosis of dementia or a fall in the last 30 days. Implications for nursing practice, education and research are discussed.

Pain and hospice care in nursing home residents with dementia and terminal cancer

“…Mitchell et al found that approximately 2% of nursing home residents die from advanced dementia and cancer. 19 The MDS is carried out quarterly, and with a change in resident status and is completed by multiple providers 39,40 who are responsible for charting diagnoses and medication administration. An assumption is that the data were coded and entered correctly in the nursing home databases, MDS records and the medication administration records.…”

Potentially Reversible Resident Factors Associated with Rejection of Care Behaviors

“…Delirium was associated with rejection of care in the analysis. Although delirium has been reported to be common in NHs, [44][45][46] its recognition remains challenging. 47 The Confusion Assessment Method, a sensitive measure to detect delirium, was used.…”

Nurse Practitioners' and Physicians' Care Activities and Clinical Outcomes With an Inpatient Geriatric Population

“…The questionnaire asked respondents to rank these activities from highest priority (1) to lowest priority (7). The rank-order portion presented (in alphabetical order) the following practice activities, which the literature identifies as being common among gerontology practitioners and as affecting recovery from illness: cognitive assessment, including screening for delirium, depression, acute confusion, and dementia (Inouye, 1998;Mentes, Culp, Maas, & Rantz, 1999;Rockwood, 1993;Zal, 1999); discharge planning (Berkman, 1995;Nicholias & Leuner, 1991); discussion of advance directives (Basile, 1998;Gamble, McDonald, & Lichstein, 1991;Tierney et al, 2001); assessment of functional status (Inouye et al, 1993); pain management (Loeb, 1999); assessment of need for physical or occupational therapy (Corcoran, 1991;Narain et al, 1998); and wound/skin assessment (Brandeis, Berlowitz, Hossain, & Morris, 1995;Young, 1989). Demographic items asked for discipline classification and specialty only.…”