2.50
Hdl Handle:
http://hdl.handle.net/10755/154689
Type:
Presentation
Title:
Acute confusion and cognitive impairment in home care
Abstract:
Acute confusion and cognitive impairment in home care
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Anderson, Mary, PhD
P.I. Institution Name:University of Illinois at Chicago
Title:Associate Professor
Objective: To explore the impact of acute confusion and other cognitive impairments in the Home Health Care (HHC) setting. Acute confusion, characterized by abrupt onset of impaired memory, disorganized thinking, and perceptual disturbances that fluctuate in intensity (Foreman, 1993), has been documented in the hospital setting, but little investigation has been done in HHC. Health care resources expended in the care of acutely confused patients are unknown. Additionally, acute confusion may account for poor HHC patient outcomes, including hospital readmission. Thus, the purposes of this project were to determine in the HHC setting: (1) evidence of acute confusion; (2) health care resources used; and (3) factors associated with hospital readmission. Design: A retrospective, descriptive design was used in this investigation. Setting & Sample: Data were collected at two HHC agencies, one in an urban location and the other in a rural site. One hundred-twenty, closed-case HHC patient records (60 rural agency, 60 urban agency), purposively selected, comprised the sample of this project. Inclusion criteria were HHC records of patients at least 65 years of age, who had received at least one skilled HHC service, and who had been referred for HHC following hospital discharge. Criteria for exclusion included presence of a coma-like state, primary diagnosis of a psychiatric disorder, increased intracranial pressure, intracranial tumor, or evidence of terminal care. Concepts, Variables Studied Together: Evidence of acute confusion was determined using the Medicare Home Health Care Quality Assurance and Improvement Demonstration Outcome and Assessment Information Set (OASIS-B). Data were collected concerning the home health care resources used by a patient using the Resource Utilization Inventory (RUI) (Anderson, Pena, & Helms, 1998). Finally, factors associated with hospital readmission during the home care service delivery period were determined using the Hospital Readmission Inventory (HRI) (Anderson, Hanson, DeVilder, & Helms, 1996). All data collection tools were designed to be used with a medical-chart audit format, and all data collection tools had established psychometric properties. Methods: Data were collected over a six-month period by two researchers. Data were coded and entered into the SPSS, a statistical data management program. After cleaning the resulting data set, data were analyzed using descriptive and simple inferential statistics. Findings: Findings suggest that the incidence of acute confusion was lower than prior reports. When comparing non-cognitively impaired HHC patients and those with confusional states, the length of HHC stay, the number of medications, and hospital readmission were not significantly different. However, confused or cognitively impaired patients had longer HHC visits, more problems with medication management, less improvement in status, and poorer overall recovery. Implications: Acute confusion is amenable to nursing intervention. Systematic documentation of the presence of acute confusion and other cognitive impairments in HHC patients is needed to facilitate nursing interventions that may reduce resource utilization and improve patient outcomes.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAcute confusion and cognitive impairment in home careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154689-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Acute confusion and cognitive impairment in home care</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Anderson, Mary, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Illinois at Chicago</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">maa928@uic.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: To explore the impact of acute confusion and other cognitive impairments in the Home Health Care (HHC) setting. Acute confusion, characterized by abrupt onset of impaired memory, disorganized thinking, and perceptual disturbances that fluctuate in intensity (Foreman, 1993), has been documented in the hospital setting, but little investigation has been done in HHC. Health care resources expended in the care of acutely confused patients are unknown. Additionally, acute confusion may account for poor HHC patient outcomes, including hospital readmission. Thus, the purposes of this project were to determine in the HHC setting: (1) evidence of acute confusion; (2) health care resources used; and (3) factors associated with hospital readmission. Design: A retrospective, descriptive design was used in this investigation. Setting &amp; Sample: Data were collected at two HHC agencies, one in an urban location and the other in a rural site. One hundred-twenty, closed-case HHC patient records (60 rural agency, 60 urban agency), purposively selected, comprised the sample of this project. Inclusion criteria were HHC records of patients at least 65 years of age, who had received at least one skilled HHC service, and who had been referred for HHC following hospital discharge. Criteria for exclusion included presence of a coma-like state, primary diagnosis of a psychiatric disorder, increased intracranial pressure, intracranial tumor, or evidence of terminal care. Concepts, Variables Studied Together: Evidence of acute confusion was determined using the Medicare Home Health Care Quality Assurance and Improvement Demonstration Outcome and Assessment Information Set (OASIS-B). Data were collected concerning the home health care resources used by a patient using the Resource Utilization Inventory (RUI) (Anderson, Pena, &amp; Helms, 1998). Finally, factors associated with hospital readmission during the home care service delivery period were determined using the Hospital Readmission Inventory (HRI) (Anderson, Hanson, DeVilder, &amp; Helms, 1996). All data collection tools were designed to be used with a medical-chart audit format, and all data collection tools had established psychometric properties. Methods: Data were collected over a six-month period by two researchers. Data were coded and entered into the SPSS, a statistical data management program. After cleaning the resulting data set, data were analyzed using descriptive and simple inferential statistics. Findings: Findings suggest that the incidence of acute confusion was lower than prior reports. When comparing non-cognitively impaired HHC patients and those with confusional states, the length of HHC stay, the number of medications, and hospital readmission were not significantly different. However, confused or cognitively impaired patients had longer HHC visits, more problems with medication management, less improvement in status, and poorer overall recovery. Implications: Acute confusion is amenable to nursing intervention. Systematic documentation of the presence of acute confusion and other cognitive impairments in HHC patients is needed to facilitate nursing interventions that may reduce resource utilization and improve patient outcomes.</td></tr></table>en_GB
dc.date.available2011-10-26T13:11:57Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T13:11:57Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.