Diagnosis and Risk Factors for Delirium in Elderly Patients in the Emergency Rooms and Intensive Care Unit of the National Geriatric Hospital Emergency Department: A Cross-Sectional Observational Study
Abstract:Purpose: To diagnose delirium and identify risk factors for its development in elderly patients in the emergency department (ED) and intensive care units (ICU) at the National Geriatric Hospital (Vietnam). Patients and Methods: A cross-sectional observational study was conducted with a convenience sample of non-surgical patients admitted to ED and ICU at Hanoi National Geriatric Hospital in Vietnam. In total, 163 patients met the selection criteria and were included in the study. Screening involved using the C… Show more
“…It has been found that hearing impairment has an effect on the development of delirium. There are studies reporting that hearing impairment is an important risk factor for delirium 40,41 . It was found that, among all ICUs, being hospitalized in the internal ICU had an 11.84 times greater effect on the development of delirium than being treated in the coronary ICU.…”
Section: Discussionmentioning
confidence: 99%
“…There are studies reporting that hearing impairment is an important risk factor for delirium. 40,41 It was found that, among all ICUs, being hospitalized in the internal ICU had an 11.84 times greater effect on the development of delirium than being treated in the coronary ICU. This may be because of the structure of the coronary ICU in the institution where the study was conducted.…”
Section: B Level Of Sedation and Level Of Consciousnessmentioning
BackgroundDelirium, which is frequently encountered in intensive care patients, can be prevented with multicomponent nursing interventions, and thus the negative consequences can be reduced.AimTo examine the effect of using eye masks and earplugs in preventing delirium in intensive care units (ICUs).Study DesignA randomized, controlled, single‐blind intervention study.MethodsThis study was conducted in the medical and surgical ICUs of a tertiary hospital, and nurses were given pre‐study training on delirium risks, diagnosis, prevention, and management. Data were collected using the patient information form, the Nursing Delirium Screening Scale, the Richard–Campbell Sleep Scale, and the daily follow‐up form. Various environmental modifications were made in the ICUs for all patients, and evidence‐based nonpharmacological nursing interventions were applied to the patients in both groups during the day and night shifts for 3 days. In addition, the patients in the intervention group were provided with eye masks and earplugs for three nights.ResultsThe study included a total of 60 patients (30 in the intervention group and 30 in the control group). There was a statistically significant difference in the development of delirium between the intervention and control groups (night of the 2nd day, p = .019; day of the 3rd day p < .001; night of the 3rd day p ≤ .001). The average total sleep quality score of the intervention group was found to be significantly higher than the control group (p ≤ .001 for three nights). Staying in the internal medicine ICU affected (odds ratio [OR], 11.84; 95% confidence interval [CI], 3.00–46.66; p = .017) more on the development of delirium than in coronary ICU, being in the age group of 65 and over, having a hearing impairment, coming to ICU from the operating room, and education level had an effect.ConclusionsThe earplugs and eye masks used by the intensive care patients overnight were found to be effective in increasing sleep quality and preventing delirium.Relevance to Clinical PracticeThe use of eye masks and earplugs is recommended for ICUs in preventing delirium.
“…It has been found that hearing impairment has an effect on the development of delirium. There are studies reporting that hearing impairment is an important risk factor for delirium 40,41 . It was found that, among all ICUs, being hospitalized in the internal ICU had an 11.84 times greater effect on the development of delirium than being treated in the coronary ICU.…”
Section: Discussionmentioning
confidence: 99%
“…There are studies reporting that hearing impairment is an important risk factor for delirium. 40,41 It was found that, among all ICUs, being hospitalized in the internal ICU had an 11.84 times greater effect on the development of delirium than being treated in the coronary ICU. This may be because of the structure of the coronary ICU in the institution where the study was conducted.…”
Section: B Level Of Sedation and Level Of Consciousnessmentioning
BackgroundDelirium, which is frequently encountered in intensive care patients, can be prevented with multicomponent nursing interventions, and thus the negative consequences can be reduced.AimTo examine the effect of using eye masks and earplugs in preventing delirium in intensive care units (ICUs).Study DesignA randomized, controlled, single‐blind intervention study.MethodsThis study was conducted in the medical and surgical ICUs of a tertiary hospital, and nurses were given pre‐study training on delirium risks, diagnosis, prevention, and management. Data were collected using the patient information form, the Nursing Delirium Screening Scale, the Richard–Campbell Sleep Scale, and the daily follow‐up form. Various environmental modifications were made in the ICUs for all patients, and evidence‐based nonpharmacological nursing interventions were applied to the patients in both groups during the day and night shifts for 3 days. In addition, the patients in the intervention group were provided with eye masks and earplugs for three nights.ResultsThe study included a total of 60 patients (30 in the intervention group and 30 in the control group). There was a statistically significant difference in the development of delirium between the intervention and control groups (night of the 2nd day, p = .019; day of the 3rd day p < .001; night of the 3rd day p ≤ .001). The average total sleep quality score of the intervention group was found to be significantly higher than the control group (p ≤ .001 for three nights). Staying in the internal medicine ICU affected (odds ratio [OR], 11.84; 95% confidence interval [CI], 3.00–46.66; p = .017) more on the development of delirium than in coronary ICU, being in the age group of 65 and over, having a hearing impairment, coming to ICU from the operating room, and education level had an effect.ConclusionsThe earplugs and eye masks used by the intensive care patients overnight were found to be effective in increasing sleep quality and preventing delirium.Relevance to Clinical PracticeThe use of eye masks and earplugs is recommended for ICUs in preventing delirium.
“…2 Its consequences are highly deleterious in patients since it causes more days of mechanical ventilation, longer stay in Intensive Care Units (ICU), higher risk of infections and even higher mortality. 3 , 4 Thus, it is important to prevent delirium, starting with its timely detection, 5 since this is one of the main measures for its prevention and treatment. 6 , 7 The Pain, Agitation and Delirium (PAD) guidelines, 8 the ABCDEF bundle 9 and the Humanizing Intensive Care Units (HU-CI) project 10 confirm that the assessment of delirium using validated scales should be performed frequently so that timely preventive measures can be developed, even from the suspicion or probability of its presence.…”
Objective. This work aimed to determine the validity and reliability of the Colombian Spanish version of the Nursing Delirium Screening Scale (Nu-DESC).
Methods. A psychometric study was conducted to achieve the goal of this study, which measured face validity, content validity, sensitivity, specificity and predictive values of the Nu-DESC.
Results. Face validity obtained a total Aiken V of 0.89, and content validity showed a modified Lawshe index of 0.92. When Nu-DESC was applied to 210 adult patients hospitalized in the Intensive Care Unit, it was found that 14.2% had suspected delirium. The instrument showed a sensitivity of 91.6%, specificity of 95.6%, positive predictive value of 73.3%, negative predictive value of 98.8%, good internal consistency with Cronbach's α of 0.8 and good concordance according to Cohen's Kappa index of 0.788.
Conclusion. The Spanish version of the Nu-DESC scale for Colombia has appropriate psychometric values for assessing delirium risk. In addition, this scale is easy to apply, so the adaptation of nursing personnel for its employability favors routine monitoring and timely detection of delirium.
“…One of the major determinants of delirium is old age [ 7 ]. In addition, risk factors include severity of illness, previous dementia, malnutrition, emergency surgery or trauma prior to ICU admission, mechanical ventilation, and anxiety [ 8 , 9 , 10 ]. There are also risk factors that are modifiable.…”
Delirium in ICU patients is a complication associated with many adverse consequences. Given the high prevalence of this complication in critically ill patients, it is essential to develop and implement an effective management protocol to prevent delirium. Given that the cause of delirium is multifactorial, non-pharmacological multicomponent interventions are promising strategies for delirium prevention. (1) Background: To identify and evaluate published systematic review on non-pharmacological nursing interventions to prevent delirium in intensive care unit patients. (2) Methods: An umbrella review guided by the Joanna Briggs Institute was utilized. Data were obtained from PubMed, Scopus, EBSCO, Web of Science, Cochrane Library, and Google Scholar. The last search was conducted on 1 May 2022. (3) Results: Fourteen reviews met the inclusion criteria. Multicomponent interventions are the most promising methods in the fight against delirium. The patient’s family is an important part of the process and should be included in the delirium prevention scheme. Light therapy can improve the patient’s circadian rhythm and thus contribute to reducing the incidence of delirium. (4) Conclusions: Non-pharmacological nursing interventions may be effective in preventing and reducing the duration of delirium in ICU patients.
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