![]() Table 9.1 provides a list of predisposing (currently existing) and precipitating (potential causes) for delirium. There are “rapid” tools and questions that can assist in identifying those at risk from delirium. Assessment can be problematic in emergency/urgent care where time is limited, especially where best practice relies on patients proceeding to surgery as soon as possible. In the surgical setting, this should be done early in the preoperative period. Prevention is more effective than a cure, with any intervention needing to begin early. ![]() This invariably leads to it being poorly recognised and managed, resulting in increased stress and anxiety for patients, relatives and staff faced with the acutely unwell, rapidly deteriorating, delirious patient. There is rarely one single predictor of delirium, with it often being a multifactorial combination of long-standing and acute factors. Interventions are often only implemented after the patient has developed delirium, with the delirium usually an indicator that the patient is acutely unwell. Managing delirium is challenging, especially when the patient is unable to articulate how they are feeling or is resistant to treatment. More likely to die in the short and long term More likely to require long-term care/support on discharge Increased stay in hospital or high dependency/critical care in hospital More hospital-associated complications (pressure injuries, falls) It is a serious condition that is associated with poor outcomes (see Box 9.1), but it can be prevented and treated with early assessment and intervention. It is categorised by a sudden onset of fluctuating altered consciousness with changes to perception and cognitive function. ![]() Delirium, sometimes called “acute confusional state”, is common and can occur after any surgical procedure, with an incidence of up to 60% after hip fracture. All nurses are familiar with the patient who suddenly becomes agitated, aggressive or “not right”. Delirium is terrifying for the patient (with approximately 50% recalling the episode) and distressing for family and care workers. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |