scholarly journals Comparison of delirium detection tools in acute care

2022 ◽  
Author(s):  
Simone Brefka ◽  
Gerhard Wilhelm Eschweiler ◽  
Dhayana Dallmeier ◽  
Michael Denkinger ◽  
Christoph Leinert
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Rapid Review ◽  
Special Focus ◽  
Clinical Settings ◽  
Care Hospital ◽  
Cognitive Changes ◽  
Medline Search

Abstract Background Delirium is a frequent psychopathological syndrome in geriatric patients. It is sometimes the only symptom of acute illness and bears a high risk for complications. Therefore, feasible assessments are needed for delirium detection. Objective and methods Rapid review of available delirium assessments based on a current Medline search and cross-reference check with a special focus on those implemented in acute care hospital settings. Results A total of 75 delirium detection tools were identified. Many focused on inattention as well as acute onset and/or fluctuating course of cognitive changes as key features for delirium. A range of assessments are based on the confusion assessment method (CAM) that has been adapted for various clinical settings. The need for a collateral history, time resources and staff training are major challenges in delirium assessment. Latest tests address these through a two-step approach, such as the ultrabrief (UB) CAM or by optional assessment of temporal aspects of cognitive changes (4 As test, 4AT). Most delirium screening assessments are validated for patient interviews, some are suitable for monitoring delirium symptoms over time or diagnosing delirium based on collateral history only. Conclusion Besides the CAM the 4AT has become well-established in acute care because of its good psychometric properties and practicability. There are several other instruments extending and improving the possibilities of delirium detection in different clinical settings.

Assessment of inattention in the context of delirium screening: one size does not fit all!

2016 ◽  
Vol 28 (8) ◽  
pp. 1293-1301 ◽  
Author(s):  
Philippe Voyer ◽  
Nathalie Champoux ◽  
Johanne Desrosiers ◽  
Philippe Landreville ◽  
Johanne Monette ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sensitivity And Specificity ◽  
Secondary Analysis ◽  
Acute Care Hospital ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Entire Group ◽  
Care Hospital ◽  
Term Care ◽  
High Prevalence

ABSTRACTBackground:Despite its high prevalence and deleterious consequences, delirium often goes undetected in older hospitalized patients and long-term care (LTC) residents. Inattention is a core symptom of this syndrome. The aim of this study was to explore the usefulness of ten simple and objective attention tests that would enable efficient delirium screening among this population.Methods:This was a secondary analysis (n = 191) of a validation study conducted in one acute care hospital (ACH) and one LTC facility among older adults with, or without, cognitive impairment. The attention test tasks (n = 10) were drawn from the Concentration subscale the Hierarchic Dementia Scale (HDS). Delirium was defined as meeting the criteria for DSM-5 delirium. The Confusion Assessment Method (CAM) was used to determine the presence of delirium symptoms.Results:The Months of the Year Backward (MOTYB) test, which 57% of participants completed successfully, showed the best balance between sensitivity and specificity (82.6%; 95% CI [61.2–95.0], and 62.5%; 95% CI [54.7–69.8] respectively) for the entire group. Subgroup analyses revealed that no test had both sensitivity and specificity over 50% in participants with cognitive impairment indicated in their medical chart.Conclusions:Our results revealed that these tests varied greatly in performance and none can be earmarked to become a single-item screening tool for delirium among older patients and residents with, or without, cognitive impairment. The presence of premorbid cognitive impairment may necessitate more extensive assessments of delirium, especially when a change in general status or mental state is observed.

Comparative Evaluation of Malnutrition Screening in Oncology Patients in an Acute Care Hospital: A Pilot Study

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Sinha Chandni Sen ◽  
LaSalle Colette ◽  
Argabright Debra ◽  
Hollenbeck Clarie B
Keyword(s):  
Pilot Study ◽  
Acute Care ◽  
Comparative Evaluation ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Oncology Patients

A Taxonomy for Psycho-Oncological Intervention Techniques in an Acute Care Hospital in Germany

2021 ◽  
pp. 1-7
Author(s):  
Martina Madl ◽  
Marietta Lieb ◽  
Katharina Schieber ◽  
Tobias Hepp ◽  
Yesim Erim
Keyword(s):  
Acute Care ◽  
Interrater Reliability ◽  
Acute Care Hospital ◽  
Future Research ◽  
Systematic Research ◽  
Care Hospital ◽  
Certification System ◽  
Stepwise Procedure ◽  
Further Development

<b><i>Background:</i></b> Due to the establishment of a nationwide certification system for cancer centers in Germany, the availability of psycho-oncological services for cancer patients has increased substantially. However, little is known about the specific intervention techniques that are applied during sessions in an acute care hospital, since a standardized taxonomy is lacking. With this study, we aimed at the investigation of psycho-oncological intervention techniques and the development of a comprehensive and structured taxonomy thereof. <b><i>Methods:</i></b> In a stepwise procedure, a team of psycho-oncologists generated a data pool of interventions and definitions that were tested in clinical practice during a pilot phase. After an adaptation of intervention techniques, interrater reliability (IRR) was attained by rating 10 previously recorded psycho-oncological sessions. A classification of interventions into superordinate categories was performed, supported by cluster analysis. <b><i>Results:</i></b> Between April and June 2017, 980 psycho-oncological sessions took place. The experts agreed on a total number of 22 intervention techniques. An IRR of 89% for 2 independent psycho-oncological raters was reached. The 22 techniques were classified into 5 superordinate categories. <b><i>Discussion/Conclusion:</i></b> We developed a comprehensive and structured taxonomy of psycho-oncological intervention techniques in an acute care hospital that provides a standardized basis for systematic research and applied care. We expect our work to be continuously subjected to further development: future research should evaluate and expand our taxonomy to other contexts and care settings.

scholarly journals Cognitive and Functional Impairment of Hospitalized Patients over 65 Years of Age

2013 ◽  
Vol 4 (1) ◽  
pp. 5-18
Author(s):  
Mª José Calero-García ◽  
Alfonso J. Cruz Lendínez
Keyword(s):  
Cognitive Impairment ◽  
Marital Status ◽  
Acute Care ◽  
Functional Impairment ◽  
Acute Care Hospital ◽  
Education Level ◽  
Care Hospital ◽  
Elderly Men ◽  
Time Of Admission ◽  
The Relationship

The first objective of this research is to establish and study how the different stages of cognitive impairment and the levels of dependence evolve in patients over 65 years of age, admitted to an acute care hospital, as well as the relationship between these factors and the different social and demographical variables. The results show that the level of dependence decreases suddenly at the time of admission and undergoes a slight recovery at the time of discharge. Although this recovery continues at home after discharge, patients do not get the same level of independence that they used to have before admission. In addition, significant differences in terms of age, marital status and education level were found. In general, our results show that elderly men over 80 years of age, without no education and widowers are more likely to suffer from severe cognitive impairment and be more functionally dependent when admitted to hospital.

scholarly journals Investigation of a Group A Streptococcal Outbreak Among Residents of a Long-term Acute Care Hospital

2011 ◽  
Vol 52 (8) ◽  
pp. 988-994 ◽  
Author(s):  
M. Deutscher ◽  
S. Schillie ◽  
C. Gould ◽  
J. Baumbach ◽  
M. Mueller ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Group A
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