Monday, 23 July 2018: 8:30 AM-9:45 AM STTI Australia
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1 Shu-Ming Chen RN, PhD, Assistant Professor, College of Nursing, Fooyin University, Kaohsiung, Taiwan, R. O.C. 29th International Nursing Research Congress Monday, 23 July 2018: 8:30 AM-9:45 AM STTI Australia
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3 Delirium is a common problem for elderly hospitalized patients for relocation The prevalence of delirium is 1%-2% in aged 65 years and older Aged older than 85 years rising to 10% The prevalence of delirium superimposed on dementia ranged form 22% to 89% of hospitalized and community populations aged 65 years and older with dementia
4 65% of doctors and 43% nurses could not identify the delirium problems of hospitalized elderly people Factors contributing to the under-recognition of delirium by registered nurses Inadequate delirium education Communication barriers Inadequate use of delirium assessment tools Lack of conceptual understanding of delirium The similarity of delirium and dementia
5 Predisposing factors Precipitating factors High vulnerability Noxious insults Low vulnerability Less noxious insults Modified from Lnouye SK., Westendorp RG., Saczynski, JS. Delirium in elderly people. Lancet, 2013.
6 Characterized by acute confusion with changes in perception, attention, cognitions sensation in complex mental status Mental status of the patient is suddenly changed to be insensitive toward time, paces and individuals Four types of delirium, overacted (irritable and aggressive), low reacted (delayed response and low psychomotor), combined (both symptoms), unspecific
7 Delirium occurs in a short period accompanied by daily changes in cognitive behavior and psychological symptoms, such as inattention short memory, insomnia sleep disturbances, irritable behavior, delusion, and illusion The fluctuating process of consciousness, cognition, memory orientation and verbalization lasting from a few hours to a few days
8 Demographic Physical factors 3-5% hip and knee surgeries would experience acute confusion or delirium for a specific period Cognitive Functional psychosocial
9 Medical diagnosis systems- DSM-III-R, DSM-IV, DSM-IV-TR Cognitive assessment The short portable mental status questionnaire (SPMSQ), the minimental status examination (MMSE), DOS scale, NEECHAM The confusion assessment method- ICU (CAM- ICU), the Groningen frailty indicator (GFI), Hasegawa s dementia scale-revised (HDS-R)
10 Post surgery complications Decreased physical and cognitive functions, Accidental falls, Longer hospitalization, Increased payment for hospitalization, Increase the incidence of illness patients dependence and death rates
11 The recommend in the future research study The recommend in the future clinical care The recommend in the delirium education
12 1. Balogun, S. A., & Philbrick, J. T. (2014). Delirium, a symptom of UTI in the elderly: fact or fable? a systematic review. Canadian Geriatrics Journal, 17(1), Gusmao-Flores, D., Salluh, J. I. F., Chalhub, R. V., & Quarantini, L. C. (2012). The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Critical Care, 16(4), R Hussein, M. E., Hirst, S., & Salyers, V. (2015). Factors that contribute to underrecognition of delirium by registered nurses in acute care settings: a scoping review of the literature to explain this phenomenon. Journal of Clinical Nursing, 24(7-8), Khan, B. A., Zawahiri, M., Campbell, N. L., Fox, G. C., Weinstein, E. J., Nazir, A.,... Boustani, M. A. (2012). Delirium in hospitalized patients: implications of current evidence on clinical practice and future avenues for research a systematic evidence review. Journal of Hospital Medicine, 7(7), Martinez, F., Tobar, C., & Hill, N. (2015). Preventing delirium: should nonpharmacological, multicomponent interventions be used? A systematic review and meta-analysis of the literature. Age and Ageing, Oresanya, L. B., Lyons, W. L., & Finlayson, E. (2014). Preoperative assessment of the older patient: a narrative review. JAMA, 311(20), Chen, S. M., & Ku, Y. L. (2018, August). Integrate literature review of delirium on the elders. Journal of Gerontology & Geriatric Research, 6(4), 1-3.
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