DEVELOPMENT OF A PLAN FOR THE EARLY DETECTION AND INTERVENTION FOR DELIRIUM IN PATIENTS WITH CANCER

2.50
Hdl Handle:
http://hdl.handle.net/10755/165127
Category:
Abstract
Type:
Presentation
Title:
DEVELOPMENT OF A PLAN FOR THE EARLY DETECTION AND INTERVENTION FOR DELIRIUM IN PATIENTS WITH CANCER
Author(s):
Slusser, Kim; Tokarz Vancura, Lesley; Holmes Gobel, Barbara
Author Details:
Kim Slusser, RN, BSN, CHPN, Nurse Manager, Northwestern Memorial Hospital, Chicago, Illinois, USA, email: kslusser@nmh.org; Lesley Tokarz Vancura, RN, MS, CNP; Barbara Holmes Gobel, RN, MS, AOCN
Abstract:
During a falls quality improvement project, it was noted that 35% of patients admitted to the oncology units who fell had developed mental status changes during their admission. Delirium was also reported in patients anecdotally by nurses. An Evidence Based Practice (EBP) journal club was formed to develop a plan for early detection of delirium and identification of evidence based nursing interventions to prevent or minimize the experience and negative outcomes of delirium. The journal club consisting of oncology nurses met every three weeks to review the literature. The initial screening tool determined to be useful in the assessment of the oncology patient was the portable mini mental status exam. It was decided this would be an excellent screening tool for admission to determine if the patient has any underlying cognitive disorders such as dementia. Then, multiple delirium assessment scales were reviewed and discussed for reliability, validity, and applicability for the oncology population. The instrument also had to be short and easy for the staff nurse to utilize, ensuring compliance and accurate findings. The Confusion Assessment (CAM) instrument was chosen. It met all the criteria and had established use with oncology patients. Review of the literature on nursing interventions for delirium yielded very little research data. Expert opinion and published practice guidelines were used as the basis for developing guidelines for delirium interventions. Oncology nurses were educated on the importance of assessing for mental status changes and appropriate interventions for the oncology patient experiencing delirium. Delirium assessment and interventions were added to the annual RN competency training for oncology. As a result of the journal club findings and recommendations, change in practice is being pursued which includes the portable mini mental status exam on admission, CAM assessments every 12 hours, and the implementation of delirium interventions based on the CAM results. This model is in its final stages of approval with the anticipated implementation to occur by winter of 2007. Once approved, the use of the assessment tools and implementation of interventions will be audited for compliance and for impact on patientÆs mental status.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, 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_US
dc.typePresentationen_GB
dc.titleDEVELOPMENT OF A PLAN FOR THE EARLY DETECTION AND INTERVENTION FOR DELIRIUM IN PATIENTS WITH CANCERen_GB
dc.contributor.authorSlusser, Kimen_US
dc.contributor.authorTokarz Vancura, Lesleyen_US
dc.contributor.authorHolmes Gobel, Barbaraen_US
dc.author.detailsKim Slusser, RN, BSN, CHPN, Nurse Manager, Northwestern Memorial Hospital, Chicago, Illinois, USA, email: kslusser@nmh.org; Lesley Tokarz Vancura, RN, MS, CNP; Barbara Holmes Gobel, RN, MS, AOCNen_US
dc.identifier.urihttp://hdl.handle.net/10755/165127-
dc.description.abstractDuring a falls quality improvement project, it was noted that 35% of patients admitted to the oncology units who fell had developed mental status changes during their admission. Delirium was also reported in patients anecdotally by nurses. An Evidence Based Practice (EBP) journal club was formed to develop a plan for early detection of delirium and identification of evidence based nursing interventions to prevent or minimize the experience and negative outcomes of delirium. The journal club consisting of oncology nurses met every three weeks to review the literature. The initial screening tool determined to be useful in the assessment of the oncology patient was the portable mini mental status exam. It was decided this would be an excellent screening tool for admission to determine if the patient has any underlying cognitive disorders such as dementia. Then, multiple delirium assessment scales were reviewed and discussed for reliability, validity, and applicability for the oncology population. The instrument also had to be short and easy for the staff nurse to utilize, ensuring compliance and accurate findings. The Confusion Assessment (CAM) instrument was chosen. It met all the criteria and had established use with oncology patients. Review of the literature on nursing interventions for delirium yielded very little research data. Expert opinion and published practice guidelines were used as the basis for developing guidelines for delirium interventions. Oncology nurses were educated on the importance of assessing for mental status changes and appropriate interventions for the oncology patient experiencing delirium. Delirium assessment and interventions were added to the annual RN competency training for oncology. As a result of the journal club findings and recommendations, change in practice is being pursued which includes the portable mini mental status exam on admission, CAM assessments every 12 hours, and the implementation of delirium interventions based on the CAM results. This model is in its final stages of approval with the anticipated implementation to occur by winter of 2007. Once approved, the use of the assessment tools and implementation of interventions will be audited for compliance and for impact on patientÆs mental status.en_GB
dc.date.available2011-10-27T12:13:00Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:13:00Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
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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