Intensive and Critical Care Nursing,
Journal Year:
2024,
Volume and Issue:
81, P. 103603 - 103603
Published: Jan. 3, 2024
The
primary
purpose
was
to
examine
sleep
difficulties
and
delirium
in
the
Intensive
Intermediate
Care
Unit.
Secondarily,
factors
impacting
night-time
duration
quality,
mortality,
impact
of
benzodiazepine
use
on
outcomes
were
investigated.
This
retrospective
study
encompassed
data
from
323
intensive
intermediate
care
unit
admissions
collected
Netherlands,
spanning
November
2018
May
2020.
Sleep
quality
measured
using
Richards-Campbell
Questionnaire.
Night-time
nurse-reported.
We
investigated
associations
these
with
age,
sex,
length-of-stay,
natural
daylight,
disease
severity,
mechanical
ventilation,
use,
Generalized
Estimating
Equations
models.
Associations
one-year
post-discharge
mortality
analyzed
Cox
regression.
short
(median
4.5
hours)
poor
(mean
score
4.9/10).
Benzodiazepine
common
(24
%
included
nights)
negatively
associated
(B
=
-0.558
-0.533,
p
<.001).
Delirium
overnight
transfers
-0.716
−1.831,
<.05).
day-to-night
ratio
higher
three
days
before
onset
than
non-delirious
individuals
(p
Age,
severity
female
sex
increased
mortality.
negatively,
but
not-significantly,
=.070).
critical
environment
has
a
quality.
not
improved
sleep.
patterns
change
ahead
onset.
Consistent
monitoring
should
be
part
routine
nursing
practice,
validated
instrument
like
Given
lack
proven
efficacy
benzodiazepines
promoting
settings,
it
is
vital
develop
more
effective
treatments
that
include
non-benzodiazepine
medication
hygiene
strategies.
Delirium Communications,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Feb. 5, 2024
Background
Delirium
is
an
acute
change
in
mental
status
that
affects
more
than
2.6
million
hospitalised
adults
annually.
Patients
who
experience
delirium
suffer
extended
hospital
stays
and
increased
mortality
morbidity.
screening
fundamental
driving
prevention
early
detection.
This
project
aimed
to
examine
assessment,
recognition
for
patients
over
18,
barriers
implementing
treatment,
report
qualitative
findings
care.
Method
In
mid-March
2023,
11
Clinical
Nurse
Leaders
the
Southeast
Region
of
United
States
participated
a
study
increase
awareness
called
World
Awareness
Day.
Data
was
collected
using
online
survey
assess
unit
census,
number
CAM
assessments,
positive
at
8:00
A.M
(+/-
4
hrs)
PM
hrs).
were
defined
as
having
if
their
electronic
healthcare
record
documentation
reflected
least
one
occurrence
score.
The
comprised
39
“select
all
apply”
questions
three
open-ended
questions.
Results
show
418
(64%)
assessments
completed.
Greater
compliance
found
during
morning
assessment
evening
shift.
Differences
nursing
practice
opinions
also
identified
between
General
High
Acuity
Units.
Among
receiving
2%
(8:00
A.M.)
3%
P.M.).
There
significant
difference
use
multi-professional
daily
goals
two
types
non-pharmacologic
intervention
(General:
0%
vs.
Acuity:
100%,
p=.003).
Barriers
identified:
shortage
personnel,
interprofessional
communication
gaps,
difficult-to-assess
patients.
Recommendations
care
include
staff
education
EHR
tool
remind
nurses
document
delirium.
Conclusion
Findings
from
this
reveal
need
education,
support,
enhancement
resources
promote
prevention.
Neurourology and Urodynamics,
Journal Year:
2021,
Volume and Issue:
41(1), P. 348 - 356
Published: Oct. 31, 2021
Abstract
Objective
To
determine
if
OAB
anticholinergics
have
an
increased
risk
of
delirium
or
falls/fractures
relative
to
beta‐3
agonist
medications.
Methods
This
was
a
retrospective,
cohort
study
using
linked
administrative
data
from
the
universal
healthcare
system
Ontario,
Canada.
Participants
were
all
residents
>66
years
age
who
newly
initiated
medication
between
January
2016
and
March
2020.
Coprimary
outcomes
evidence
hospital
visit
with
delirium,
for
fall/fracture.
We
used
matching
weights
make
three
exposure
groups
(beta‐3
agonist,
oxybutynin,
newer
anticholinergics)
comparable
across
82
baseline
characteristics.
examined
both
during
first
30
days
(logistic
regression)
continuous
usage
(proportional
hazards).
Results
identified
103
024
older
adults
started
With
weights,
measured
variables
similar.
The
30‐day
incidence
0.31%,
fall/fracture
1.07%;
there
no
significantly
either
(oxybutynin
users
OR
1.28
[95%
CI
0.84–1.96],
anticholinergic
0.92
0.58–1.46])
1.19
0.95–1.49],
1.14
0.91–1.43])
compared
users.
usage,
HR
among
(HR
1.13,
95%
1.02–1.26)
oxybutynin
1.02–1.24).
Conclusions
Compared
agonists,
use
is
associated
fall/fracture,
are
delirium.
Clinical Medicine,
Journal Year:
2022,
Volume and Issue:
22(6), P. 522 - 524
Published: Nov. 1, 2022
The
National
Early
Warning
Score
(NEWS),
published
in
2012,
made
no
specific
adjustments
for
older
people.
updated
NEWS2
(2017)
incorporated
new
confusion
as
a
category
consciousness.
In
this
article,
we
consider
the
role
of
detection
acute
clinical
deterioration
people
and
how
score
may
be
used
to
inform
care,
highlighting
additional
aspects,
such
care
escalation
decisions,
that
ensue.
We
evidence
NEWS
assessment
person
different
settings,
including
potential
benefits
limitations
home
residents.
suggest
need
adaptation
future
iterations,
it
should
conjunction
with
other
assessments,
Clinical
Frailty
Scale
four
'A's
test
(4AT)
delirium.
