2.50
Hdl Handle:
http://hdl.handle.net/10755/243206
Category:
Full-text
Type:
Presentation
Title:
Feasibility Testing of a Technology Application at the Point of Care
Author(s):
Swan, Beth Ann
Lead Author STTI Affiliation:
Xi Chapter
Author Details:
Swan, Beth Ann, PhD, CRNP, FAAN, bethannswan@gmail.com;
Abstract:
Purpose: Delirium is under-recognized and not documented by nurses in over 85% of patients who are delirious.  Nurses play a critical role in screening for delirium because they provide 24-hour care and see the patient in a variety of circumstances.  Failure to recognize delirium can lead to serious adverse events.  The purpose of the study was to determine the effect of screening with the Confusion Assessment Method (CAM) on the recognition and management of delirium by nurses and to determine the effect of screening with the CAM on clinically recognized adverse events including falls, pressure ulcers, and restraint use in postoperative older adults undergoing hip and knee surgery.

Methods: The study employed a pre-post design with older adult patients undergoing elective hip and knee surgery.  The post-intervention phase incorporated the CAM with score alert system into a hospital-based EMR for identification of delirium at the point of care. The main powered outcome was recognition of delirium.  Secondary outcome measures were clinically recognized adverse events.

Results: The pre-phase included 161 subjects.  Eight patients had 1 positive CAM each, 1 patient had 2 positive CAMs, and 2 patients had 3 positive CAMs.  This was expected in this healthy, elective surgery population.  One subject fell post-operatively, 2 subjects developed pressure ulcers, and no subjects were restrained.  In the pre-phase, none of those patients with a positive CAM was identified by nurses as potentially suffering from delirium.  The post-phase included 120 subjects.  In the post-phase 1 of 4 CAM-positive patients were also identified by a nurse. But in addition, the nurses also identified an additional 9 patients as suffering from delirium.

Conclusion: Feasibility was established for incorporating the CAM with score alert system into the EMR.  Nurses did use the CAM, did recognize delirium (confirmed by the RA), and implemented the recommended evidence-based interventions. 

Keywords:
Technology; Research; Delirium
Repository Posting Date:
12-Sep-2012
Date of Publication:
12-Sep-2012 ; 12-Sep-2012
Conference Date:
2012
Conference Name:
23rd International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Brisbane, Australia

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleFeasibility Testing of a Technology Application at the Point of Careen
dc.contributor.authorSwan, Beth Annen
dc.contributor.departmentXi Chapteren
dc.author.detailsSwan, Beth Ann, PhD, CRNP, FAAN, bethannswan@gmail.com;en
dc.identifier.urihttp://hdl.handle.net/10755/243206-
dc.description.abstract<b>Purpose: </b>Delirium is under-recognized and not documented by nurses in over 85% of patients who are delirious.&nbsp; Nurses play a critical role in screening for delirium because they provide 24-hour care and see the patient in a variety of circumstances.&nbsp; Failure to recognize delirium can lead to serious adverse events.&nbsp; The purpose of the study was to<b> </b>determine the effect of screening with the Confusion Assessment Method (CAM) on the recognition and management of delirium by nurses and to determine the effect of screening with the CAM on clinically recognized adverse events including falls, pressure ulcers, and restraint use in postoperative older adults undergoing hip and knee surgery. <p><b>Methods: </b>The study employed a pre-post design with older adult patients undergoing elective hip and knee surgery.&nbsp; The post-intervention phase incorporated the CAM with score alert system into a hospital-based EMR for identification of delirium at the point of care. The main powered outcome was recognition of delirium.&nbsp; Secondary outcome measures were clinically recognized adverse events. <p><b>Results: </b>The pre-phase included 161 subjects.&nbsp; Eight patients had 1 positive CAM each, 1 patient had 2 positive CAMs, and 2 patients had 3 positive CAMs.&nbsp; This was expected in this healthy, elective surgery population.&nbsp; One subject fell post-operatively, 2 subjects developed pressure ulcers, and no subjects were restrained.&nbsp; In the pre-phase, none of those patients with a positive CAM was identified by nurses as potentially suffering from delirium.&nbsp; The post-phase included 120 subjects.&nbsp; In the post-phase 1 of 4 CAM-positive patients were also identified by a nurse. But in addition, the nurses also identified an additional 9 patients as suffering from delirium. <p><b>Conclusion: </b>Feasibility was established for incorporating the CAM with score alert system into the EMR.&nbsp; Nurses did use the CAM, did recognize delirium (confirmed by the RA), and implemented the recommended evidence-based interventions.&nbsp;en
dc.subjectTechnologyen
dc.subjectResearchen
dc.subjectDeliriumen
dc.date.available2012-09-12T09:19:00Z-
dc.date.issued2012-09-12-
dc.date.issued2012-09-12en
dc.date.accessioned2012-09-12T09:19:00Z-
dc.conference.date2012en
dc.conference.name23rd International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationBrisbane, Australiaen
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