Implications of Objective vs Subjective Delirium Assessment in Surgical Intensive Care Patients

Capacitação de enfermeiros na utilização de um instrumento de avaliação de delirium

“…Delirium is the most common neurological disorder in patients hospitalized in intensive care units (ICUs) with an incidence of 5 and 92% (1)(2) . It is associated with an increased hospital stay length, hospital costs, use of sedatives and mechanical restrictions, the accidental removal of catheters and tubes and increased mortality.…”

Insights and Advances in Multidisciplinary Critical Care: A Review of Recent Research

“…Guenther and colleagues 88 assessed the frequency of discrepancies between subjective and objective delirium monitoring. They compared a daily rating of patients' delirium status by bedside nurses, based on their clinical assessment, with a daily assessment www.ajcconline.org Systematic pain assessment can improve outcomes, and several assessment tools are now available.…”

Correction

“…As a result, comparisons of diagnostic methods for detecting delirium will inevitably produce different results, 1 and training in a particular diagnostic method will inevitably improve agreement with other assessors using that method. 2 In delirium diagnosis, it most important for clinicians and researchers to identify a diagnostic strategy that (1) identifies patients at higher risk of adverse outcome, independent of other markers of disease severity, and (2) identifies patients who will benefit from therapy.…”

“…1,2 Realizing that bedside delirium screening is not a replacement for a formal diagnostic evaluation by either a psychiatrist or neurologist, it nevertheless remains an efficient, low-risk assessment that will help ICU clinicians address reversible causes for delirium (when delirium is suspected), avoid treatments for agitation known to worsen delirium (eg, benzodiazepines), and promote regular interdisciplinary discussion regarding the cognitive status of all patients.…”