RESEARCH CONSIDERATIONS: Delirium in Hospitalized Elders

Abstract

1. If a nurse does not detect delirium in a hospitalized patient, the results can be catastrophic. 2. Nurses need more education regarding the assessment and recognition of the symptoms of delirium. 3. The assessment of delirium should include more than simply questions about orientation, and should include the aspects of sleep-wake disturbances, perceptual and psychomotor manifestations.

Nurses' Recognition of Delirium in the Hospitalized Older Adult

“…20 In addition, several studies report that because nurses tend to focus on orientation, they fail to detect the significant cognitive deficits associated with delirium. 15,21 In a study of 797 patients prospectively enrolled from a larger observational epidemiological study in the United States, with a mean age of 78 years, nurse and researcher CAM ratings were paired. 12 The incidence of delirium was 16% (131/797), with nurses making diagnostically accurate decisions (overall sensitivity) only 19.3% of the time.…”

Assessing severity of delirium by the delirium observation screening scale

“…Due to the fluctuating nature and different presentations of the condition, the severity of delirium might be difficult to assess by once‐daily visits by physicians. Compared to physicians, nurses have more frequent round‐the‐clock contact with patients and are in a strategic position to observe changes in behaviour (Morency et al ., 1994). The Delirium Observation Screening (DOS) Scale was originally designed for nurses to screen for the presence of delirium.…”

Accuracy of nurse documentation of delirium symptoms in medical charts

“…That being so, the terms used to describe the delirium symptoms are also important. Nurses and physicians often use vague and inconsistent terminology to describe a patient's mental state 13,25,26,28,29 . Nurses tend touse the term ‘confused’ to report cognitive impairment.…”