2.50
Hdl Handle:
http://hdl.handle.net/10755/160059
Type:
Presentation
Title:
Assessment of Delirium and Depression in the ICU
Abstract:
Assessment of Delirium and Depression in the ICU
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2006
Author:Idemoto, Bette, PhD, RN, CCRN, CS
P.I. Institution Name:University Hospitals of Cleveland
Title:Clinical Nurse Specialist
Contact Address:Medical/Surgical Nursing, 11100 Euclid Avenue - Wearn 5057, Cleveland, OH, 44106, USA
Contact Telephone:216-844-2202
The intent of the study was to examine the accuracy of critical care nurses' clinical assessment of delirium and depression compared to standardized validated tools. Accuracy of nurses' assessment of these syndromes can be improved. Studies have shown high incidence, poor outcomes and long-term sequelae for ICU patients who experience delirium or depression. 126 adult post-operative patients with greater 24-hour stays in the Surgical ICU of a large urban medical center were assessed and compared to the nurses' assessments caring for the patients on the day of interview. The Confusion Assessment Method-Intensive Ca4e Unit was used (CAM-ICU) for delirium, and the Hospital Anxiety and Depression Scale (HADS-D, depression subscale) to assess depression, and the nurse caring for the patient was asked for an informal clinical assessment. Following study completion, data was examined for concordance using percent agreement and the Kappa statistic. Logistic regression was used to assess the influence of patient characteristics (age, gender, race, hospital day of interview, and primary procedure or diagnosis) and selected nurse characteristics (RN gender, educational preparation, years of nursing experience) to assess the accuracy of the nurses' judgment. The regression model for depression was significant with these predictors of concordance: hospital day (OR 1.119, p=.02) and RN years of experience (OR .725, p=.03); the regression model for delirium was not significant. Clinical significance or insights for clinical practice may be found with further analysis. Conclusions: This SICU study is the first to assess nurses' accuracy of detection of delirium and depression in post-operative ICU patients. This study has been able to demonstrate the feasibility of investigating these complex phenomena in the ICU environment and can be pivotal in building the foundation for future studies with the ultimate goal of improved patient outcomes of the critically ill patient.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAssessment of Delirium and Depression in the ICUen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160059-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Assessment of Delirium and Depression in the ICU</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Idemoto, Bette, PhD, RN, CCRN, CS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University Hospitals of Cleveland</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Medical/Surgical Nursing, 11100 Euclid Avenue - Wearn 5057, Cleveland, OH, 44106, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">216-844-2202</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bette.idemoto@uhhs.com</td></tr><tr><td colspan="2" class="item-abstract">The intent of the study was to examine the accuracy of critical care nurses' clinical assessment of delirium and depression compared to standardized validated tools. Accuracy of nurses' assessment of these syndromes can be improved. Studies have shown high incidence, poor outcomes and long-term sequelae for ICU patients who experience delirium or depression. 126 adult post-operative patients with greater 24-hour stays in the Surgical ICU of a large urban medical center were assessed and compared to the nurses' assessments caring for the patients on the day of interview. The Confusion Assessment Method-Intensive Ca4e Unit was used (CAM-ICU) for delirium, and the Hospital Anxiety and Depression Scale (HADS-D, depression subscale) to assess depression, and the nurse caring for the patient was asked for an informal clinical assessment. Following study completion, data was examined for concordance using percent agreement and the Kappa statistic. Logistic regression was used to assess the influence of patient characteristics (age, gender, race, hospital day of interview, and primary procedure or diagnosis) and selected nurse characteristics (RN gender, educational preparation, years of nursing experience) to assess the accuracy of the nurses' judgment. The regression model for depression was significant with these predictors of concordance: hospital day (OR 1.119, p=.02) and RN years of experience (OR .725, p=.03); the regression model for delirium was not significant. Clinical significance or insights for clinical practice may be found with further analysis. Conclusions: This SICU study is the first to assess nurses' accuracy of detection of delirium and depression in post-operative ICU patients. This study has been able to demonstrate the feasibility of investigating these complex phenomena in the ICU environment and can be pivotal in building the foundation for future studies with the ultimate goal of improved patient outcomes of the critically ill patient.</td></tr></table>en_GB
dc.date.available2011-10-26T22:35:15Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:35:15Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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