36.00
Hdl Handle:
http://hdl.handle.net/10755/621170
Category:
Full-text
Format:
Text-based Document
Type:
DNP Capstone Project
Level of Evidence:
Other
Research Approach:
Other
Title:
Preoperative Cognition Screening and Postoperative Delirium in Older Surgical Patients
Author(s):
Andrews, Lucy
Additional Author Information:
Lucy Andrews, DNP, RN BSN, MS Lucy@ayshomecare.net
Advisors:
Matheson, Linda; Bressie, Marylee; Hoffman, Nancy
Degree:
DNP
Degree Year:
2016
Grantor:
Capella University
Abstract:

People 65 years or older are having surgery later in life and are at risk of developing a major postoperative complication, delirium. The Montreal Cognitive Assessment, is a preoperative cognitive screening tool which was used to screen thirty-three older orthopedic surgical patients to reduce the incidence of this serious postoperative complication.  Patients who scored below normal were identified as at risk and monitored to ascertain if identification and monitoring influenced their postoperative course.  At the first postoperative visit, each patient was evaluated for falls, confusion, and the ability to follow the required postoperative home exercise program to identify an undetected episode of delirium after discharge. Of the patients screened, 34.1%  (n = 14) of patients fell below the cutoff for normal cognition. Subsequent monitoring and nursing interventions may have influenced their postoperative course as there were no reported episodes of delirium in the 90-day period.  Thus, preoperative screening with the Montreal Cognitive Assessment tool provides a baseline cognitive assessment and early identification of patients at higher risk for postoperative delirium, and therefore, identification of patients at risk for postoperative delirium may allow for early interventions and decrease postoperative delirium.

Keywords:
Delirium; COGNITIVE IMPAIRMENT; Postoperative delirium; Dementia; older adults and surgery; cognitive screening
CINAHL Headings:
Preoperative Care--Methods; Preoperative Care; Delirium--In Old Age; Delirium--Prevention and Control; Delirium--Risk Factors; Delirium; Postoperative Complications--Etiology; Postoperative Complications; Patient Assessment; Cognition Disorders--Complications; Cognition Disorders; Aged; Aged, Hospitalized
Description:
This evidence-based performance improvement project was to implement a change in nursing practice through the identification of patients at risk for delirium before surgery so that increased monitoring could be instituted to decrease the onset of delirium. Additional benefits included enhanced knowledge gained by the nursing staff through the educational information, nurse adherence to using the screening tool, and decreasing the incidence of delirium in older patients who have orthopedic surgery.
Note:
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Repository Posting Date:
2016-12-21T21:47:25Z
Date of Publication:
2016-12-21

Full metadata record

DC FieldValue Language
dc.contributor.advisorMatheson, Lindaen
dc.contributor.advisorBressie, Maryleeen
dc.contributor.advisorHoffman, Nancyen
dc.contributor.authorAndrews, Lucyen
dc.date.accessioned2016-12-21T21:47:25Z-
dc.date.available2016-12-21T21:47:25Z-
dc.date.issued2016-12-21-
dc.identifier.urihttp://hdl.handle.net/10755/621170-
dc.descriptionThis evidence-based performance improvement project was to implement a change in nursing practice through the identification of patients at risk for delirium before surgery so that increased monitoring could be instituted to decrease the onset of delirium. Additional benefits included enhanced knowledge gained by the nursing staff through the educational information, nurse adherence to using the screening tool, and decreasing the incidence of delirium in older patients who have orthopedic surgery.en
dc.description.abstract<p>People 65 years or older are having surgery later in life and are at risk of developing a major postoperative complication, delirium. The Montreal Cognitive Assessment, is a preoperative cognitive screening tool which was used to screen thirty-three older orthopedic surgical patients to reduce the incidence of this serious postoperative complication.  Patients who scored below normal were identified as <em>at risk</em> and monitored to ascertain if identification and monitoring influenced their postoperative course.  At the first postoperative visit, each patient was evaluated for falls, confusion, and the ability to follow the required postoperative home exercise program to identify an undetected episode of delirium after discharge. Of the patients screened, 34.1%  (<em>n </em>= 14) of patients fell below the cutoff for normal cognition. Subsequent monitoring and nursing interventions may have influenced their postoperative course as there were no reported episodes of delirium in the 90-day period.  Thus, preoperative screening with the Montreal Cognitive Assessment tool provides a baseline cognitive assessment and early identification of patients at higher risk for postoperative delirium, and therefore, identification of patients at risk for postoperative delirium may allow for early interventions and decrease postoperative delirium.</p>en
dc.formatText-based Documenten
dc.language.isoen_USen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectDeliriumen
dc.subjectCOGNITIVE IMPAIRMENTen
dc.subjectPostoperative deliriumen
dc.subjectDementiaen
dc.subjectolder adults and surgeryen
dc.subjectcognitive screeningen
dc.titlePreoperative Cognition Screening and Postoperative Delirium in Older Surgical Patientsen_US
dc.typeDNP Capstone Projecten
thesis.degree.grantorCapella Universityen
thesis.degree.levelDNPen
dc.description.noteThis work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.-
dc.primary-author.detailsLucy Andrews, DNP, RN BSN, MS Lucy@ayshomecare.neten
thesis.degree.year2016en
dc.type.categoryFull-texten
dc.evidence.levelOtheren
dc.research.approachOtheren
dc.subject.cinahlPreoperative Care--Methodsen
dc.subject.cinahlPreoperative Careen
dc.subject.cinahlDelirium--In Old Ageen
dc.subject.cinahlDelirium--Prevention and Controlen
dc.subject.cinahlDelirium--Risk Factorsen
dc.subject.cinahlDeliriumen
dc.subject.cinahlPostoperative Complications--Etiologyen
dc.subject.cinahlPostoperative Complicationsen
dc.subject.cinahlPatient Assessmenten
dc.subject.cinahlCognition Disorders--Complicationsen
dc.subject.cinahlCognition Disordersen
dc.subject.cinahlAgeden
dc.subject.cinahlAged, Hospitalizeden
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