Medicine and Health Sciences Commons^™

The Mini-Mental State Examination As A Diagnostic And Screening Test For Delirium: Systematic Review And Meta-Analysis, Alex J. Mitchell, Deepak Shukla, Hafsa A. Ajumal, Brendon Stubbs, Tayyeb Tahir

Brain and Mind Institute

Objective

To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults.

Method

Two authors searched MEDLINE, PsychINFO and EMBASE from inception till March 2014. Articles were included that investigated the diagnostic validity of the MMSE to detect delirium against standardised criteria. A diagnostic validity meta-analysis was conducted.

Results

Thirteen studies were included representing 2017 patients in medical settings of whom 29.4% had delirium. The meta-analysis revealed the MMSE had an overall sensitivity and specificity estimate of 84.1% and 73.0%, but this was 81.1% and …

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, …

Palliative Care Nurses' Recognition And Assessment Of Delirium Symptoms: A Qualitative Study Using Critical Incident Technique, Annmarie Hosie, Meera Agar, Elizabeth Lobb, Patricia M. Davidson, Jane Phillips

Health Sciences Papers and Journal Articles

Delirium is prevalent in palliative care inpatient settings and management is often challenging. Despite nurses’ integral patient care role, little is known about palliative care nurses’ capacity to recognise, assess and respond to patients’ delirium symptoms. Objective: To explore the experiences, views and practices of inpatient palliative care nurses in delirium recognition and assessment. Settings and participants: 30 nurses from nine Australian specialist palliative care inpatient services. Design and methods: Critical incident technique (CIT) guided a series of semi-structured interviews. Prior to interviews participants were given a vignette of a palliative care inpatient with an unrecognised hypoactive delirium, to prompt …

Identifying The Barriers And Enablers To Pallative Care Nurses' Recognition And Assessment Of Delirium Symptoms: A Qualitative Study, Annmarie Hosie, M Agar, Elizabeth A. Lobb, P M. Davidson, Jane Phillips

Nursing Papers and Journal Articles

Context: Delirium is under-recognised by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses’ delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients’ delirium outcomes.

Objective: To identify nurses’ perceptions of the barriers and enablers to recognising and assessing delirium symptoms in palliative care inpatient settings.

Methods: A series of semi-structured interviews, guided by critical incident technique, were conducted with nurses working in Australian palliative care inpatient settings. A hypoactive delirium vignette prompted participants’ recall of …

Editorial: Nurses’ Role In Improving Interdisciplinary Delirium Care In Inpatient Settings: Steps For Action, Annmarie Hosie, Jane Phillips

Nursing Papers and Journal Articles

No abstract provided.

Public Health Model Identifies Recruitment Barriers Among Older Adults With Delirium And Dementia, Margaret J. Bull, Lesley Boaz, Jennifer M. Sjostedt

College of Nursing Faculty Research and Publications

Recruiting older adults and their family caregivers into research studies presents challenges. Although the literature notes some general recruitment challenges, no studies specifically address the unique challenges of recruiting older adults who have Alzheimer's Disease (AD) and their family caregivers in studies about delirium or suggest using a framework to identify barriers to recruiting this population. In conducting a pilot study about preparing family caregivers to detect delirium symptoms in older adults with (AD) the researchers used the Public Health Model for identifying barriers to recruitment. The goals of this methodological article are to: (1) briefly describe the methodology of …

Family Caregivers’ Knowledge Of Delirium And Preferred Modalities For Receipt Of Information, Margaret J. Bull, Lesley Boaz, Jennifer M. Sjostedt

College of Nursing Faculty Research and Publications

Delirium is a life-threatening, frequently reversible condition that is often a sign of an underlying health problem. In-hospital mortality alone for older adults with delirium ranges from 25% to 33%. Early recognition of delirium is critical because prolonged duration poses a greater risk of poor functional outcomes for older adults. Family caregivers, who are familiar with the older adult’s usual behaviors, are most likely to recognize delirium symptoms but might dismiss them as due to aging. It is important to learn what family caregivers know about delirium to ascertain their need for education. The aims of this study were to …