Medicine and Health Sciences Commons^™

Effect Of Confusion Assessment Scores On Identifying Delirium In Intensive Care Patients, Kayla Jacobs

Dissertations

Delirium in intensive care unit (ICU) patients can lead to increased length of stay in the hospital, increased risk of complications, increased polypharmacy, family distress and increased rate of mortality (Vasilevskis et al., 2018). Research has shown that addressing modifiable risk factors can improve survival rate by up to 15%, and routine screening for delirium in ICU patients leads to decreased patient anxiety, reduced in-hospital mortality, early recognition, and treatment of delirium (Krewulak et al., 2021 ; Vasilevskis et al., 2018). This quality improvement project used evidence-based intervention to increase accurate documentation of the confusion assessment method in the ICU …

Evaluation Of A Process Change Using An Updated Sedation Protocol, Rachel Allen

Dissertations

Problem: Pediatric delirium is continuing to increase intensive care environments and for patients who require mechanical ventilation and continuous sedative medications. Delirium is harmful to the patient creating lasting neurologic and mental health issues along with prolonged hospitalization and increased healthcare cost

Method: For this quality improvement (QI) project, a descriptive observational study was used to evaluate the implementation of a sedation protocol for patients who are mechanically ventilated and on continuous sedative medications. This was completed with the use of retrospective chart reviews three months prior to implementation and three months after the new protocol was implemented. Nurses were …

Evaluating The Rass And Cap-D In A Pediatric Cardiac Intensive Care Unit, Sarah Anderson

Dissertations

Abstract

Problem: Pediatric delirium is highly prevalent in the intensive care setting, as much as seventy to eighty-seven percent. Kalvas & Harrison (2020) found that sixty-six percent of critically ill children in a pediatric intensive care unit suffered from a diagnosis of delirium. Delirium has been widely linked with increased costs, mortality, and length of stay.

Methods: The quality improvement (QI) project used a descriptive design to collect retrospective and prospective data before and after an individualized bedside education session was completed. The QI project used a purposive convenience sampling to assess the ability to accurately identify the presence of …

Implementing The Richmond Agitation-Sedation Scale To Assess Delirium In A Pediatric Icu, Leigh Paridy

Dissertations

Purpose: The purpose of this quality improvement project was to establish early identification of delirium in the intensive care setting to reduce the impact of long-term patient outcomes. Description of project: A retrospective-prospective medical chart review was completed. The retrospective chart review looked at fifty-two patients admitted to the pediatric intensive care unit (PICU) between October 1, 2020 and December 1, 2020 for patient demographics and State Behavior Scale (SBS) and the Cornell Assessment for Pediatric Delirium (CAPD) charting compliance especially with children with developmental delay and those with a high susceptibility to delirium. The prospective chart review looked at …

Screening For Delirium In The Emergency Department, Melissa Minks

Dissertations

Abstract

Delirium is a problem for many older adults who are acutely ill. Delirium often comes on suddenly, can be severe, and is often difficult to diagnose, especially in the presence of dementia. Missed delirium has a mortality rate of 30.8% and costs millions. What is the purpose of this study?

Methods The 4A’s Test screening instrument was implemented and evaluated in the Emergency Department of a rural Midwestern hospital from May 1, 2019 through August 31, 2019.

Results There were 122 participants in the study with 61 in each cohort. In 2018, three (5%) were diagnosed with delirium without …

Evaluation Of Sleep Hygiene Checklist For Delirium In An Intensive Care Unit, Ying Wei

Dissertations

Abstract

Problem: Delirium is a severe complication brought on by sleep deprivation that could increase mortality and prolong intensive care unit (ICU) stays in critically ill patients. This project aimed to develop and implement a sleep hygiene checklist to decrease the incidence of delirium in a Medical Intensive Care Unit (MICU).

Methods: This study used a pre-post design to compare the incidence of delirium pre-and post-implementation of the sleep hygiene checklist. Forty-four patients and thirty-six patients were recruited for the pre-and post-intervention groups, respectively.

Results: The result of this study demonstrated use of a sleep hygiene checklist could decrease the …

Veteran Specific Risk Factors For Delirium, Allison Perkins

Dissertations

Purpose/Aims: This study explored the relationships between military characteristics such as combat experience, mental health issues such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), depression, anxiety and substance use disorder (SUD), physical comorbidities such as coronary artery disease (CAD), other risk factors, and delirium diagnosis among hospitalized veterans.

Background: Delirium is a common disorder experienced by 25% of all hospitalized adults 65 years and older. No published studies to date have examined whether combat, TBI and PTSD are associated with the incidence of delirium in the hospitalized veteran.

Methods: A retrospective cross-sectional cohort design with a sample size …

Delirium Rate And Risk Factors In Palliative Care Outpatients And Caregiver Coping Strategies, Sarah Deur Livermore Phd, Fnp

Dissertations

Background: Delirium causes suffering and in terminal illness undermines important goals to die at home. Improved knowledge about delirium among palliative outpatients can lead to improved patient outcomes through early identification and treatment in the home. Conversely, a missed diagnosis leads to costly hospital admissions, and is the most common reason to seek long-term care placement (Breitbart & Alici, 2008). Medicare stresses the importance by listing it as a common cause of falls among non-reimbursed hospital events. Prior evaluation of outpatient delirium rate was 14% among demented community dwelling elders (Steis, Evans, et al., 2012a). It is hypothesized that frail, …

Relationship Between Delirium And Night-Time Interruptions In Icu, Amy R. Stuck Phd, Rn

Dissertations

Background: This dissertation examined the phenomenon of delirium in the intensive care unit (ICU) setting. Delirium is a form of cognitive disturbance with a physiologic etiology and complex, multifactorial mechanisms of causation and risk. Delirium in the ICU patient presents a significant risk for adverse outcomes including increased mortality, length of stay, falls, and restraint use. ICU delirium can lead to persistent cognitive impairment beyond discharge and frequent skilled nursing placement. Identifying delirium requires accurate diagnosis that is optimized when validated instruments are used. Sleep deprivation has been linked to adverse health consequences including delirium. Previous studies investigating the relationship …

Documentation: Delirium In The Hospitalized Older Adult, Jacqueline Fitzgerald Close Phd

Dissertations

Background: Delirium is a common, life threatening and preventable geriatric syndrome. Because this condition is frequently addressed by administering dangerous antipsychotic drugs, it is imperative that accurate systematic assessments are charted to determine the actual need for these medications. The purpose of the study was to describe medical record documentation of a systematic assessment of delirium in older adults who had been administered an antipsychotic medication. Methods: A descriptive correlational retrospective design was used for this medical record data based study. The setting was a 107 bed acute care community hospital located in southern California. Inclusion criteria were medical records …