Prevention and Management of Postoperative Delirium Among Older Patients on an Orthopedic Surgical Unit

Sykes, P

doi:10.1097/ncq.0b013e31823f8573

Cited by 20 publications

(19 citation statements)

References 17 publications

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“…Sockalingam et al .’s () review concluded that the extent to which inter‐professional activities are incorporated into IPE sessions influences the likelihood of benefits for patients from such education, via practice change. Two previous studies achieving practice change more actively engaged the staff; one included bedside coaching and the other involved unit‐based, inter‐professional, collaborative decision‐making (Sykes, ; Gordon et al ., ). Providing IPE was challenging in this study.…”

Section: Discussionmentioning

confidence: 99%

Piloting staff education in Australia to reduce falls in older hospital patients experiencing delirium

Toye

Kitchen

Hill

et al. 2016

Nursing & Health Sciences

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This study piloted a hospital-based delirium and falls education program to investigate the impacts on staff knowledge and practice plus patient falls. On a medical ward, staff knowledge was compared before and after education sessions. Other data -collected a day before and after program implementation -addressed documentation of patients' delirium and evidence of compliance with falls risk minimization protocols. These data, and numbers of patient falls, were compared before and after program implementation. Almost all ward staff members participated in education sessions (7 doctors, 7 allied health practitioners, and 45 nurses) and knowledge was significantly improved in the 22 who completed surveys both before and after session attendance. Patients assessed as having delirium (5 before implementation, 4 afterwards) were all documented as either confused or delirious. Small changes eventuated in adherence with falls risk management protocols for confused patients and the number of falls decreased. The program merits a stronger emphasis on staff activities relating to the detection, documentation, and management of delirium to inter-professional roles and communication. Evidence of practice enhancement from program implementation should precede rigorous testing of impacts upon falls.

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Section: Discussionmentioning

confidence: 99%

Piloting staff education in Australia to reduce falls in older hospital patients experiencing delirium

Toye

Kitchen

Hill

et al. 2016

Nursing & Health Sciences

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“…9,10 It has been suggested that the correction of modifiable risk factors is effective in delirium prevention and delirium prevention programs can succeed in decreasing the duration of delirium. 11,12 However, general prevention for all surgical patients is not cost-effective. Thus, a predictive model for delirium is necessary to identify high-risk patients for monitoring and proactive implementation of preventive strategies.…”

Section: Introductionmentioning

confidence: 99%

DELirium Prediction Based on Hospital Information (Delphi) in General Surgery Patients

Kim

Park²,

Kim³

et al. 2016

Medicine

104

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To develop a simple and accurate delirium prediction score that would allow identification of individuals with a high probability of postoperative delirium on the basis of preoperative and immediate postoperative data.Postoperative delirium, although transient, is associated with adverse outcomes after surgery. However, there has been no appropriate tool to predict postoperative delirium.This was a prospective observational single-center study, which consisted of the development of the DELirium Prediction based on Hospital Information (Delphi) score (n = 561) and its validation (n = 533). We collected potential risk factors for postoperative delirium, which were identified by conducting a comprehensive review of the literatures.Age, low physical activity, hearing impairment, heavy alcoholism, history of prior delirium, intensive care unit (ICU) admission, emergency surgery, open surgery, and increased preoperative C-reactive protein were identified as independent predictors of postoperative delirium. The Delphi score was generated using logistic regression coefficients. The maximum Delphi score was 15 and the optimal cut-off point identified with the Youden index was 6.5. Generated area under the (AUC) of the receiver operating characteristic (ROC) curve was 0.911 (95% CI: 0.88–0.94). In the validation study, the calculated AUC of the ROC curve based on the Delphi score was 0.938 (95% Cl: 0.91–0.97). We divided the validation cohort into the low-risk group (Delphi score 0–6) and high-risk group (7–15). Sensitivity of Delphi score was 80.8% and specificity 92.5%.Our proposed Delphi score could help health-care provider to predict the development of delirium and make possible targeted intervention to prevent delirium in high-risk surgery patients.

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“…월 동안 사망률이 2.5배 높았고, 퇴원 후 일상생활기능의 감소 도 2.2배 높았으며 (Abelha et al, 2013), 재원기간도 평균 4 일 이상 길게 보고되었다 (Robinson et al, 2009) (Robinson et al, 2009;Staus, 2011;van Meenen, van Meenen, de Rooij, & ter Riet, 2014), 고령으로 인한 취약한 기저질환 동반 (Inouye et al, 2014), 수술 후 지연되는 신체 회복 상태 (Bellelli et al, 2014), 수술로 인해 발생하는 기동력 장애 (Chung et al, 2011), 수술 후 발생하는 심각한 통증 (Staus, 2011) (Sykes, 2012).…”

Section: 수술 후 섬망이 발생한 환자는 발생하지 않은 환자에 비해 6개unclassified

Postoperative Delirium in Elderly Patients with Osteoarthritis Surgery: Incidence and Risk Factors

Park¹,

Kim²

2015

Journal of muscle and joint health

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Purpose:The purpose of this study was to evaluate the incidence of postoperative delirium in elderly patients with osteoarthritis surgery and identify risk factors for its development. Methods: This study enrolled 288 patients who underwent osteoarthritis surgery in a hospital between May and November 2014. Data were collected prospectively. The Nursing Delirium Screening Scale was used to detect delirium. Multivariable logistic regression analysis was used to identify independent risk factors for postoperative delirium. Patients were also followed for outcome. Results: Postoperative delirium developed in 42 patients (14.6%). Logistic regression analysis identified old age, low physical activity, antipsychotic agents, number of catheters, and intensive care unit admission as risk factors. Worse outcomes, including increased hospital mortality, reoperation, and discharge at care facilities, occurred in subjects who developed delirium. Conclusion: Osteoarthritis surgery in elderly patients was associated with a high incidence of postoperative delirium. The results of the this study regarding patient populations vulnerable to delirium should be taken into account so that such patients could be identified preoperatively or in the immediate postoperative period.

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Prevention and Management of Postoperative Delirium Among Older Patients on an Orthopedic Surgical Unit

Cited by 20 publications

References 17 publications

Piloting staff education in Australia to reduce falls in older hospital patients experiencing delirium

Piloting staff education in Australia to reduce falls in older hospital patients experiencing delirium

DELirium Prediction Based on Hospital Information (Delphi) in General Surgery Patients

Postoperative Delirium in Elderly Patients with Osteoarthritis Surgery: Incidence and Risk Factors

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