Association between preoperative anxiety and postoperative delirium in older patients: a systematic review and meta-analysis.

Background: Postoperative delirium (POD) is a common postoperative complication associated with multiple adverse consequences on patient outcomes and higher medical expenses. Preoperative anxiety has been suggested as a possible precipitating factor for the development of POD. As such, we aimed to explore the association between preoperative anxiety and POD in older surgical patients.

Delirium Item Bank: Utilization to Evaluate and Create Delirium Instruments.

Introduction: The large number of heterogeneous instruments in active use for identification of delirium prevents direct comparison of studies and the ability to combine results. In a recent systematic review we performed, we recommended four commonly used and well-validated instruments and subsequently harmonized them using advanced psychometric methods to develop an item bank, the Delirium Item Bank (DEL-IB). The goal of the present study was to find optimal cut-points on four existing instruments and to demonstrate use of the DEL-IB to create new instruments.

Harmonization of Four Delirium Instruments: Creating Crosswalks and the Delirium Item-Bank (DEL-IB).

Objectives: Over 30 instruments are in current, active use for delirium identification. In a recent systematic review, we recommended 4 commonly used and well-validated instruments for clinical and research use. The goal of this study is to harmonize the four instruments on the same metric using modern methods in psychometrics.

Is preoperative anxiety associated with postoperative delirium in older persons undergoing cardiac surgery? Secondary data analysis of a randomized controlled trial.

Background: Although many studies have reported numerous risk factors for postoperative delirium, data are scarce about preoperative anxiety as a risk factor. The study aimed to investigate the association between preoperative anxiety and postoperative delirium in older patients undergoing cardiac surgery.

Methods: Secondary data analysis of a randomized, observer-blind, controlled trial.

Psychometric properties of the intensive care delirium screening checklist when used by bedside nurses in clinical practice: a prospective descriptive study.

Background: The Intensive Care Delirium Screening Checklist (ICDSC) demonstrates good psychometric characteristics in research settings. However, evidence about these characteristics in pragmatic ICU settings is inconsistent. This study evaluated psychometric properties and user-friendliness of the ICDSC when administered by ICU nurses in daily practice.

Developing delirium best practice: a systematic review of education interventions for healthcare professionals working in inpatient settings.

Purpose: Understanding the quality of evidence of delirium education studies will assist in designing future education interventions that seek to improve the well-known deficits in delirium prevention, detection and care. The aim of this study is to systematically review the methodological strengths and limitations, as well as the impact of delirium educational interventions for healthcare professionals working in inpatient settings.

Methods: MEDLINE, EMBASE, The Cochrane Library, PsychINFO and CINAHL databases were searched according to PRISMA guidelines for delirium educational interventions in hospital inpatient settings from 2007 to 2017.

Effect of an interactive E-learning tool for delirium on patient and nursing outcomes in a geriatric hospital setting: findings of a before-after study.

Background: Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present.

Effect of anaemia on hand grip strength, walking speed, functionality and 1 year mortality in older hospitalized patients.

Background: Anaemia is a common problem in hospitalized older patients and is recognized as a risk factor for a significant number of adverse outcomes. Data of the effect of anaemia on functional status during hospitalization and mortality after discharge are limited. Aim of the study is to examine whether there is an association between anaemia, hand grip strength, gait speed and basic activities of daily living (ADL) during hospitalization and mortality 1 year after discharge in geriatric patients.

Evaluation of the delirium early monitoring system (DEMS).

Background: Despite awareness of the negative health and financial outcomes of delirium, systems to routinely assess and manage the condition are absent in clinical practice. We report the development and pilot evaluation of a Delirium Early Monitoring System (DEMS), designed to be completed by non-medical staff to influence clinical processes within inpatient settings. Two versions of the DEMS are described based on a modified Confusion Assessment Method (DEMS-CAM) and Delirium Observation Screening Scale (DEMS-DOSS).

The effect of an interactive delirium e-learning tool on healthcare workers' delirium recognition, knowledge and strain in caring for delirious patients: a pilot pre-test/post-test study.

Background: Studies investigating the effectiveness of delirium e-learning tools in clinical practice are scarce. The aim of this study is to determine the effect of a delirium e-learning tool on healthcare workers' delirium recognition, delirium knowledge and care strain in delirium.

Methods: A pilot pre-posttest study in a convenience sample of 59 healthcare workers recruited from medical, surgical, geronto-psychiatric and rehabilitation units of a university hospital.

Is preoperative state anxiety a risk factor for postoperative delirium among elderly hip fracture patients?

Aim: To determine if preoperative state anxiety is a risk factor for postoperative delirium in older hip fracture patients.

Methods: A secondary data analysis comprising data from a prospective non-randomized trial including 86 patients with a hip fracture aged 65 years and older was carried out. State anxiety was measured preoperatively using the State-Trait Anxiety Inventory.

Prevalence of frailty and its ability to predict in hospital delirium, falls, and 6-month mortality in hospitalized older patients.

Background: The prevalence and significance of frailty are seldom studied in hospitalized patients. Aim of this study is to evaluate the prevalence of frailty and to determine the extent that frailty predicts delirium, falls and mortality in hospitalized older patients.

Methods: In a prospective study of 220 older patients, frailty was determined using the Cardiovascular Health Study (CHS) and the Study of Osteoporotic Fracture (SOF) frailty index.

Detection of delirium in palliative care unit patients: a prospective descriptive study of the Delirium Observation Screening Scale administered by bedside nurses.

Background: The Delirium Observation Screening Scale (DOS) is designed to detect delirium by nurses' observations and has shown good psychometric properties. Its use in palliative care unit patients has not been studied.

Aim: To determine diagnostic and concurrent validity, internal consistency, and user-friendliness of the Delirium Observation Screening Scale administered by bedside nurses in palliative care unit patients.

Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation.

Objectives: To evaluate the effect of inpatient geriatric consultation teams (IGCTs), which have been introduced to improve the quality of care of older persons hospitalized on nongeriatric wards, on delirium and overall cognitive functioning in older adults with hip fracture.

Design: Controlled trial.

Setting: Two trauma wards in a university hospital setting.

The virtual gateway: opening doors in delirium teaching and learning.

Delirium is a common, serious and potentially preventable problem. It is argued here that knowledge and skills for effective assessment and treatment of delirium cannot be considered 'specialist'. Rather, delirium is a problem that requires a healthcare team approach to assessing patients, identifying risks or symptoms and reducing precipitating factors.

Is preoperative anxiety and depression associated with onset of delirium after cardiac surgery in older patients? A prospective cohort study.

Objectives: To investigate the prevalence of preoperative anxiety and depressive symptoms and their relationship with the occurrence of postcardiac delirium and to describe the evolution of these symptoms from preoperative admission until discharge.

Design: Descriptive, prospective, longitudinal study.

Setting: The intensive care unit and two cardiac surgery units in a university hospital setting.