Delirium: Prevention, Early Recognition, and Treatment

Tullmann, Dorothy; Blevins, Cheri; Fletcher, Kathy

doi:10.1891/9780826171672.0017

Cited by 4 publications

(7 citation statements)

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“…6 From these, only a summary of the NICE guideline (with an electronic link to obtain a PDF version of the guideline), an “acute confusion/delirium” guideline summary, 20 and an evidence-based geriatric nursing protocol 21 specifically referred to delirium. Additionally, the summary for an updated version of nursing guidelines for caregiving strategies for older adults with delirium, dementia, and depression also was sourced on this repository.…”

Section: Resultsmentioning

confidence: 99%

Clinical Practice Guidelines for Delirium Management: Potential Application in Palliative Care

Bush

Bruera

Lawlor

et al. 2014

Journal of Pain and Symptom Management

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Context Delirium occurs in patients across a wide array of health care settings. The extent to which formal management guidelines exist or are adaptable to palliative care is unclear. Objectives This review aims to 1) source published delirium management guidelines with potential relevance to palliative care settings, 2) discuss the process of guideline development, 3) appraise their clinical utility, and 4) outline the processes of their implementation and evaluation and make recommendations for future guideline development. Methods We searched PubMed (1990–2013), Scopus, U.S. National Guideline Clearinghouse, Google, and relevant reference lists to identify published guidelines for the management of delirium. This was supplemented with multidisciplinary input from delirium researchers and other relevant stakeholders at an international delirium study planning meeting. Results There is a paucity of high-level evidence for pharmacological and non-pharmacological interventions in the management of delirium in palliative care. However, multiple delirium guidelines for clinical practice have been developed, with recommendations derived from “expert opinion” for areas where research evidence is lacking. In addition to their potential benefits, limitations of clinical guidelines warrant consideration. Guidelines should be appraised and then adapted for use in a particular setting before implementation. Further research is needed on the evaluation of guidelines, as disseminated and implemented in a clinical setting, focusing on measurable outcomes in addition to their impact on quality of care. Conclusion Delirium clinical guidelines are available but the level of evidence is limited. More robust evidence is required for future guideline development.

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Section: Resultsmentioning

confidence: 99%

Clinical Practice Guidelines for Delirium Management: Potential Application in Palliative Care

Bush

Bruera

Lawlor

et al. 2014

Journal of Pain and Symptom Management

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“…Consistent with previous South Korean studies (Choi et al., ; Lee et al., ), RNs in this study said that there was a need for hospital management to develop comprehensive policies and protocols that promote delirium care practice in the workplace. Internationally, research increasingly recommends the use of a standardised protocol for delirium prevention and management in hospital settings (National Institute for Health and Clinical Excellence, ; Tullmann et al., ). Thus, it is important to develop and implement such a protocol and relevant policies in the study hospital site.…”

Section: Discussionmentioning

confidence: 99%

Qualitative evaluation of a delirium prevention and management programme

Kang

Moyle

Cooke

et al. 2017

Journal of Clinical Nursing

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“…Early removal of urinary catheter devices and implementation of normal toileting practices (eg, bedside commode, offering urinal), frequent rounds, use of moisture wicking underpads, reorientation with specific questions concerning elimination needs, and review of medications that may increase urgency/need to void are important nursing interventions in the management of patients with acute delirium. 114,115 Similarly, indwelling urinary catheters are not indicated as a primary intervention to manage moisture-related skin breakdown. 106,108,109 Skin care interventions to manage incontinence, such as moisture barrier creams and moisture wicking products, should be explored before insertion of a urinary catheter.…”

Section: Related Beliefs and Current Evidencementioning

confidence: 99%