Intensive Care Unit Nurses' Beliefs About Delirium Assessment and Management.

Delirium, the most frequent complication of hospitalized older adults, particularly in intensive care units (ICUs), can result in increased mortality rates and length of stay. Nurses are neither consistently identifying nor managing delirium in these patients. The purpose of this study was to explore ICU nurses' identification of delirium, actions they would take for patients with signs or symptoms of delirium, and beliefs about delirium assessment and management.

Effect of hospice nonprofessional caregiver barriers to pain management on adherence to analgesic administration recommendations and patient outcomes.

Nonprofessional caregivers frequently experience barriers to using analgesics for pain in patients in home hospice settings, and patients in pain may suffer needlessly. For example, caregiver adherence to the administration of analgesics is lower for as-needed (PRN) regimens than for standard around-the-clock regimens. But little is known about the barriers caregivers experience and the effects of those barriers.

Nurses' recognition of delirium in the hospitalized older adult.

Background: Delirium is the most frequent complication associated with hospitalization of older adults, responsible for 17.5 million additional hospital days in the United States each year; yet, nurses fail to recognize it more than 30% of the time.

Objectives: The specific aim of the study was to measure staff nurses' recognition of delirium in hospitalized older adults by comparing nurse and expert diagnostician ratings for delirium using the Confusion Assessment Method (CAM).

Model for the First NIH-funded Center of Excellence in End-of-Life Research.

Centers of excellence are widely acknowledged as a mechanism to promote scientific advances in a particular field of science, but until recently there have been no end-of-life or palliative care research centers funded by the National Institutes of Health (NIH). The purpose of this article is to describe aims, framework, and organizational structure of the first NIH-funded Center of Excellence on end-of-life research, the Center for End-of-Life Transition Research (CEoLTR), and the advances in end-of-life research that the CEoLTR will facilitate. The teams of researchers involved in the CEoLTR have grown impressively since it was funded in 2007.

Case studies: is the sleep of hospitalized elders related to delirium?

Four cases are presented to compare sleep, light, and sound levels of patients who developed delirium to patients who did not develop delirium, and to determine the effect of light and sound stimuli upon awakenings from sleep.

Cognitive assessment and differentiating the 3 Ds (dementia, depression, delirium).

Differentiation between a diminished or altered cognitive functioning asa consequence of aging and one resulting from serious health problems is critical in the elderly. An unrecognized cognitive disorder or the worsening of the impairment may hamper the effectiveness and appropriateness of care and treatment; therefore, standardized assessment procedures and systematic monitoring of cognition and behavior are important aspects of the nursing care. of older adults.

Multicomponent intervention strategies for managing delirium in hospitalized older people: systematic review.

Aim: The aim of this systematic review was to determine the characteristics and efficacy of various multicomponent intervention strategies for delirium in hospitalized older people.

Background: Delirium is a common accompaniment to acute illness in hospitalized older people and has greater costs of care concurrent as well as greater morbidity and mortality.

Methods: A comprehensive search was undertaken involving all major databases (including the Cochrane Library, Medline, Cumulative Index for Nursing and Allied Health Literature and Invert) and reference lists of all relevant papers.

Hospital readmission from home health care before and after prospective payment.

Purpose: To describe and compare clients who were readmitted to the hospital during an episode of home health care, before and after the inception of the prospective payment system (PPS).

Design: A longitudinal mixed design was used to replicate a study conducted 9 years previously (pre-PPS) in the same home care agency in the central part of the United States.

Methods: Seventy-six closed-case medical records from a not-for-profit hospital-affiliated home care agency were retrospectively reviewed and compared to pre-PPS data.

Psychometric properties of the Flemish translation of the NEECHAM Confusion Scale.

Background: Determination of a patient's cognitive status by use of a valid and reliable screening instrument is of major importance as early recognition and accurate diagnosis of delirium is necessary for effective management. This study determined the reliability, validity and diagnostic value of the Flemish translation of the NEECHAM Confusion Scale.

Methods: A sample of 54 elderly hip fracture patients with a mean age of 80.

The Strain of Care for Delirium Index: a new instrument to assess nurses' strain in caring for patients with delirium.

This study evaluated content validity, internal consistency and construct validity of the Strain of Care for Delirium Index (SCDI), a newly constructed instrument to measure the strain nurses experience in caring for patients with delirium. Content validity, evaluated by eight experts, reduced the initial pool of items from 38 to 28. Using a convenience sample of 190 nurses, Cronbach's alpha for the 28-item version was 0.

Documentation of delirium in elderly patients with hip fracture.

This study determined the accuracy of diagnosis and documentation of delirium in the medical and nursing records of 55 elderly patients with hip fracture (mean age = 78.4, SD = 8.4).