Multicentre study of delirium in ICU patients using a simple screening tool

Roberts, Brigit; Rickard, Claire M; Rajbhandari, Dorrilyn; Turner, Gillian; Clarke, Jane; Hill, Dianne; Tauschke, Christine; Chaboyer, Wendy; Parsons, Richard

doi:10.1016/s1036-7314(05)80019-0

Cited by 87 publications

(70 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As part of this process, the ICDSC was chosen as the delirium screening tool because of its ease of use, its ability to be used in patients with an impaired ability to communicate, and its ability to identify subsyndromal delirium. [31][32][33] Since the Richmond Agitation Sedation Scale (RASS) was already in use at this institution, the first ICDSC domain was adapted to include a RASS score for each descriptor of level of consciousness (Appendix 1). 34 The ICDSC worksheet was also modified so that each ICDSC domain contained both expanded descriptions and key questions that could be used by clinicians to determine whether an abnormality in a particular domain was present.…”

Section: Methodsmentioning

confidence: 99%

Impact of a Delirium Screening Tool and Multifaceted Education on Nurses’ Knowledge of Delirium and Ability to Evaluate It Correctly

Gesin

Russell

Lin

et al. 2012

American Journal of Critical Care

View full text Add to dashboard Cite

BackgroundThe impact of using a validated delirium screening tool and different levels of education on surgical-trauma intensive care unit (STICU) nurses’ knowledge about delirium is unclear.ObjectivesTo measure the impact of using the Intensive Care Delirium Screening Checklist (ICDSC), with or without a multi-faceted education program, on STICU nurses’ knowledge and perceptions of delirium and their ability to evaluate it correctly.MethodsThe knowledge and perceptions of subject nurses about delirium, and agreement between the independent assessments of delirium by the subject nurse and by a validated judge (who always used the ICDSC), were compared across 3 phases. Phase 1: No delirium screening tool and no education. Phase 2: ICDSC and minimal education (ie, ICDSC validation study only). Phase 3: ICDSC and multifaceted education (ie, pharmacist-led didactic lecture, Web-based module, and nurse-led bedside training).ResultsNurses’ knowledge (mean [SD] score out of 10 points) was similar (P = .08) in phase 1 (6.1 [1.4]) and phase 2 (6.5 [1.4]) but was greater (P = .001) in phase 3 (8.2 [1.4]). Agreement between nurses and the validated judge in the assessment of delirium increased from phase 1 (κ = 0.40) to phase 2 (κ = 0.62) to phase 3 (κ = 0.74). Nurses perceived use of the ICDSC as improving their ability to recognize delirium.ConclusionsUse of a multifaceted education program improves both nurses’ knowledge about delirium and their perceptions about its recognition. Implementation of the ICDSC improves the ability of STICU nurses to evaluate delirium correctly.

show abstract

Section: Methodsmentioning

confidence: 99%

Impact of a Delirium Screening Tool and Multifaceted Education on Nurses’ Knowledge of Delirium and Ability to Evaluate It Correctly

Gesin

Russell

Lin

et al. 2012

American Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…For instance, a study showed a prevalence of delirium as high as 77% in ventilated burn patients [5]. The incidence of delirium in the ICU ranges from 45% to 87% [6-8]. The incidence appears to vary according to whether the studied population is composed exclusively of mechanically ventilated patients.…”

Section: Epidemiologymentioning

confidence: 99%

Delirium in the ICU: an overview

Cavallazzi

Saad

Marik

2012

Ann. Intensive Care

224

155

View full text Add to dashboard Cite

Delirium is characterized by a disturbance of consciousness with accompanying change in cognition. Delirium typically manifests as a constellation of symptoms with an acute onset and a fluctuating course. Delirium is extremely common in the intensive care unit (ICU) especially amongst mechanically ventilated patients. Three subtypes have been recognized: hyperactive, hypoactive, and mixed. Delirium is frequently undiagnosed unless specific diagnostic instruments are used. The CAM-ICU is the most widely studied and validated diagnostic instrument. However, the accuracy of this tool may be less than ideal without adequate training of the providers applying it. The presence of delirium has important prognostic implications; in mechanically ventilated patients it is associated with a 2.5-fold increase in short-term mortality and a 3.2-fold increase in 6-month mortality. Nonpharmacological approaches, such as physical and occupational therapy, decrease the duration of delirium and should be encouraged. Pharmacological treatment for delirium traditionally includes haloperidol; however, more data for haloperidol are needed given the paucity of placebo-controlled trials testing its efficacy to treat delirium in the ICU. Second-generation antipsychotics have emerged as an alternative for the treatment of delirium, and they may have a better safety profile. Dexmedetomidine may prove to be a valuable adjunctive agent for patients with delirium in the ICU.

show abstract

“…19,25,26,33 These factors also vary according to the type of surgery undertaken. For example, precipitating factors for postoperative delirium in cardiothoracic surgical patients include admission to the intensive care unit and invasive monitoring, 34,35 cardiopulmonary bypass, 36,37 and hypothermic states. 37 In patients undergoing abdominal surgery, intraoperative tachycardia, 19 long duration of surgery, 33 abnormal melatonin levels, 24 and disturbances in the sleep-wake cycle 38,39 were specific additional predictors.…”

mentioning

confidence: 99%

Postoperative Delirium After Colorectal Surgery in Older Patients

Mangnall¹,

Gallagher²,

Stein‐Parbury³

2010

American Journal of Critical Care

View full text Add to dashboard Cite

Background Postoperative delirium in older patients results in worse outcomes and increased costs. The prevalence and predictors of postoperative delirium in patients undergoing major colorectal surgery are not clear. Objectives To determine the prevalence and predictors of postoperative delirium in older patients after major colorectal surgery. Methods Patients older than 50 years, without preexisting cognitive impairment, were recruited before surgery. These patients were assessed after surgery for delirium daily for 3 days by using the Confusion Assessment Method. Regression analysis was used to determine independent predictors of postoperative delirium. Results Patients (n = 118) had a mean age of 71.81 years, and approximately half were women (54%). Most participants (64%) were married, and comorbid conditions were common. Delirium developed in 35% of the patients in the 3 days after surgery and in 21% in the first 24 hours. New cases of delirium were identified on each of the 3 days after surgery, and a few patients (7%) had delirium for the entire 3 days. Odds for delirium in the first 24 hours were increased for patients who had early admission (odds ratio [OR] = 4.48; P = .06) and decreased for patients who were married (OR = 0.25; P = .01). Odds for delirium in the first 3 days after surgery were increased for men (OR = 4.27; P = .02), older patients (OR = 1.05; P = .04), and patients who stayed overnight in the critical care unit (OR = 2.97; P = .06). Conclusions Postoperative delirium is common and persistent in older patients in the first 3 days after colorectal surgery.

show abstract

Multicentre study of delirium in ICU patients using a simple screening tool

Cited by 87 publications

References 42 publications

Impact of a Delirium Screening Tool and Multifaceted Education on Nurses’ Knowledge of Delirium and Ability to Evaluate It Correctly

Impact of a Delirium Screening Tool and Multifaceted Education on Nurses’ Knowledge of Delirium and Ability to Evaluate It Correctly

Delirium in the ICU: an overview

Postoperative Delirium After Colorectal Surgery in Older Patients

Contact Info

Product

Resources

About