2.50
Hdl Handle:
http://hdl.handle.net/10755/157153
Category:
Abstract
Type:
Presentation
Title:
Delirium Assessment in SICU
Author(s):
Pagano, Diane
Author Details:
Diane Pagano, Flagler Hospital, St. Augustine, Florida, USA, email: diane.pagano@flaglerhospital.org
Abstract:
PURPOSE: Assessing delirium in ICU patients has shown to identify patients with higher mortality rates, longer length of stay, and added costs. Would the same results be seen in a surgical intensive care unit where patients have a 2.6 day length of stay? The CAM ICU tool was used to assess patients to determine if similar results would be obtained in a short stay unit. BACKGROUND: Delirium in the ICU has been associated with an increased length of stay from 5 to 8 days. Hospital length of stay is increased from 11 to 21 days. Costs associated with the additional time in the hospital will increase from $13,000 to $22,000, and there is an increase of three times the mortality associated with delirium. (Ely, Jama 2001). The CAM-ICU tool was selected for its ease of use and the ability to monitor ventilator patients who are nonverbal. METHODS: Data collection continued for 90 days in a 12 bed SICU. Nurses assessed patients every 12 hours. In patients where positive results occurred, nursing interventions were implemented and physicians were approached about the need for a psychiatry consult. (See tool and intervention). Random patients were selected to confirm the validity of the data collection. Daily census reports were compared with the number of delirium assessments done each day, and ongoing one-on-one updates assisted the staff when their results were in question or when an assessment had been missed. RESULTS: 304 patients were studied and of these 43 were positive for delirium. 12 of the 43 patients expired during the 90 day period resulting in 27.9% mortality. The patients who were not delirious had a 7.6% rate of mortality. Length of stay in the ICU for the patients with delirium was 5.42 days as opposed to 2.12 days for the patients without delirium. All but one patient identified, were found to have had several drugs prescribed that would alter the central nervous system. 19 received hydromorphone, 10 were given haloperidol, 16 had midazolam, 28 had lorazapam. 15 were given morphine for pain control and 21 were on propofol. CONCLUSIONS: Although most nurses can tell you by experience that confused patients require more care and have longer length of stay, the CAM-ICU tool provides a means to measure and identify these patients beyond disorientation to time and place. Determining delirium in a short stay ICU can identify patients who are delirious, and therefore identify those with a higher mortality rate and length of stay.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleDelirium Assessment in SICUen_GB
dc.contributor.authorPagano, Dianeen_GB
dc.author.detailsDiane Pagano, Flagler Hospital, St. Augustine, Florida, USA, email: diane.pagano@flaglerhospital.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157153-
dc.description.abstractPURPOSE: Assessing delirium in ICU patients has shown to identify patients with higher mortality rates, longer length of stay, and added costs. Would the same results be seen in a surgical intensive care unit where patients have a 2.6 day length of stay? The CAM ICU tool was used to assess patients to determine if similar results would be obtained in a short stay unit. BACKGROUND: Delirium in the ICU has been associated with an increased length of stay from 5 to 8 days. Hospital length of stay is increased from 11 to 21 days. Costs associated with the additional time in the hospital will increase from $13,000 to $22,000, and there is an increase of three times the mortality associated with delirium. (Ely, Jama 2001). The CAM-ICU tool was selected for its ease of use and the ability to monitor ventilator patients who are nonverbal. METHODS: Data collection continued for 90 days in a 12 bed SICU. Nurses assessed patients every 12 hours. In patients where positive results occurred, nursing interventions were implemented and physicians were approached about the need for a psychiatry consult. (See tool and intervention). Random patients were selected to confirm the validity of the data collection. Daily census reports were compared with the number of delirium assessments done each day, and ongoing one-on-one updates assisted the staff when their results were in question or when an assessment had been missed. RESULTS: 304 patients were studied and of these 43 were positive for delirium. 12 of the 43 patients expired during the 90 day period resulting in 27.9% mortality. The patients who were not delirious had a 7.6% rate of mortality. Length of stay in the ICU for the patients with delirium was 5.42 days as opposed to 2.12 days for the patients without delirium. All but one patient identified, were found to have had several drugs prescribed that would alter the central nervous system. 19 received hydromorphone, 10 were given haloperidol, 16 had midazolam, 28 had lorazapam. 15 were given morphine for pain control and 21 were on propofol. CONCLUSIONS: Although most nurses can tell you by experience that confused patients require more care and have longer length of stay, the CAM-ICU tool provides a means to measure and identify these patients beyond disorientation to time and place. Determining delirium in a short stay ICU can identify patients who are delirious, and therefore identify those with a higher mortality rate and length of stay.en_GB
dc.date.available2011-10-26T19:28:07Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:28:07Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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