Detecting pediatric delirium: development of a rapid observational assessment tool

Silver, Gabrielle; Traube, Chani; Kearney, Julia; Kelly, Daniel P.; Yoon, Margaret J.; Moyal, Wendy Nash; Gangopadhyay, Maalobeeka; Shao, Huibo; Ward, Mary J.

doi:10.1007/s00134-012-2518-z

Cited by 129 publications

(135 citation statements)

References 33 publications

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“…It is associated with worse outcomes, longer length of stay, more cognitive impairment and higher mortality rates in adults up until three times higher than the general population, along 6 months of observation. 4,[68][69][70] The prevalence in adults is well established, varying from 45 to 87% of the patients in ICUs. 69,70 In pediatrics, there are still few studies, with some of then showing a prevalence of 4-29%.…”

Section: Resultsmentioning

confidence: 99%

“…So, the use of evaluation scales every 8 to 12 hours is recommended. 4,[68][69][70] In pediatrics, there is still no consensus regarding the best method. Options include the p-CAM (pediatric Confusion Assessment Method), derived from the CAM scale, for children older than 5 years of age, and the CAP-D (Cornell Assessment Pediatric Delirium tool) for children between 0-18 years old.…”

Section: Resultsmentioning

confidence: 99%

“…Options include the p-CAM (pediatric Confusion Assessment Method), derived from the CAM scale, for children older than 5 years of age, and the CAP-D (Cornell Assessment Pediatric Delirium tool) for children between 0-18 years old. 4,68,70,72 discussion Promotion of comfort and lowering of anxiety, fear, and anguish is part of the daily routine of a pediatric intensive care physician. The use of an excessive dosage of sedatives and analgesics leads to worse outcomes, with longer periods of immobilization, more sleep-awake cycle disturbances and delirium, increase in time of mechanical ventilation and hospital length of stay, higher treatment costs.…”

Section: Resultsmentioning

confidence: 99%

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Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit

Motta

Luglio²,

Delgado

et al. 2016

Rev. Assoc. Med. Bras.

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Summary Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols. Objective: Literature review on the main aspects of analgesia and sedation, abstinence syndrome, and delirium in the pediatric intensive care unit, in order to show the importance of the use of protocols on the management of critically ill patients. Method: Articles published in the past 16 years on PubMed, Lilacs, and the Cochrane Library, with the terms analgesia, sedation, abstinence syndrome, mild sedation, daily interruption, and intensive care unit. Results: Seventy-six articles considered relevant were selected to describe the importance of using a protocol of sedation and analgesia. They recommended mild sedation and the use of assessment scales, daily interruptions, and spontaneous breathing test. These measures shorten the time of mechanical ventilation, as well as length of hospital stay, and help to control abstinence and delirium, without increasing the risk of morbidity and morbidity. Conclusion: Despite the lack of controlled and randomized clinical trials in the pediatric setting, the use of protocols, optimizing mild sedation, leads to decreased morbidity.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit

Motta

Luglio²,

Delgado

et al. 2016

Rev. Assoc. Med. Bras.

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“…The CAPD is an observational screening tool designed to assess critically ill children of all ages for delirium. 11 It has never been formally tested in a NICU population but has been validated in infants. 8 The CAPD was used in 2 of the infants we present (4 and 11 weeks' corrected aged).…”

Section: Discussionmentioning

confidence: 99%

Detection and Management of Delirium in the Neonatal Unit: A Case Series

2016

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“…If nurses don't have the necessary knowledge and skills to evaluate child carefully, they cannot intervene early enough to prevent further deterioration that increase length of hospital stay [10].…”

Section: Introductionmentioning

confidence: 99%

Learning Needs Assessment of Pediatric Nurses Regarding Delirium and Its Barriers of Screening at Intensive Care Units

Abusaad¹,

Mostafa²,

Ibraheim³

2017

AJNR

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Pediatric delirium is a significant issue among critically ill children; Professional and highly qualified nurses are usually the first who identify delirium in ICU patients, with a need for close monitoring, recognition, and prevention. Aim of the study was to assess learning needs of critical care nurses regarding pediatric delirium and its barrier of screening at ICUs. Method: A descriptive design was conducted on a purposive sample of 91 pediatric critical care nurses working at Mansoura University Children's hospital and New Mansoura General hospital who fulfills the criteria of selection using pediatric nurses learning needs structured questionnaire that includes questions about characteristics of studied nurses, nurse's knowledge, attitude and practice about pediatric delirium and barriers of delirium screening among pediatric critical care nurses. Results: the level of nurses' knowledge was poor in 94.5%, fair in 5.5% and there was any one with good knowledge, the negative attitude toward delirium was reported in 54.9% of nurses, while only 3.3% of nurses has positive attitude and the level of practice was unsatisfactory in 81.3% of nurses. The most common barriers for delirium screening as reported by the studied nurses is absent of tool to evaluate delirium (86.8%), difficult to determine delirium in children on ventilator (78.0%) and inefficient of symptoms registering in children taking sedation (70.3%). Conclusions: the majority of studied nurses have poor knowledge about pediatric delirium particularly for its definition, causes and its management. Also, more than half of them has negative attitude regarding delirium and majority of them has unsatisfactory practice. The commonest barriers for delirium screening were absent of tool and difficulties of delirium screening for children on ventilator at ICUs. Recommendation: pediatric critical care nurses learning needs should be assessed constantly and progressively through implementing educational training program to increase competences of Pediatric ICUs staff focused on practical guidelines for hospitalized children with delirium.

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Detecting pediatric delirium: development of a rapid observational assessment tool

Abstract: The CAP-D may be a valid screen for identification of delirium in PICU patients of all ages. Further studies are required to explore its validity, inter-rater reliability, and feasibility of use as a nursing screen.

Cited by 129 publications

References 33 publications

Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit

Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit

Detection and Management of Delirium in the Neonatal Unit: A Case Series

Learning Needs Assessment of Pediatric Nurses Regarding Delirium and Its Barriers of Screening at Intensive Care Units

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