A recent study revealed a more accurate, efficient way to identify delirium in your patients, which may help you with your day-to-day work as a travel nurse.
About delirium
Delirium, while reversible, can be costly and deadly, according to distinguished professor of nursing and co-director of the Hartford Center of Geriatric Nursing Excellence at Pennsylvania State University, Donna Fick.
The Cleveland Clinic described delirium as a sudden confusion or change in the state of someone’s mental status. Delirium is independent of chronic dementia such as Alzheimer’s Disease and often develops over a few hours or days. The Mayo Clinic said that delirium results in changes in behavior, declined cognitive skills and reduced recognition of one’s environment.
Cases of delirium are more prevalent in hospitals, according to the Cleveland Clinic. Specifically, 10 to 30 percent of hospital patients experience delirium. That number jumps to 50 percent for people in high-risk populations for delirium such as cancer patients, HIV patients, ICU patients and patients older than 75 years old.
Hyperactive delirium and hypoactive delirium are the two types of delirium. Each has its own warning signs and symptoms. Patients with hyperactive delirium are anxious, emotional, restless and hallucinate. On the other hand, hypoactive delirium patients experience apathy, withdrawal, laziness and are less responsive.
Study overview
Fick and Edward Marcantonio, professor of medicine at Harvard Medical School, wanted to come up with a simpler method to determine patients with delirium to help nurses with their daily workload, according to a press release.
Prior to the recent method, the quickest test for delirium was a three minute, three-dimensional Confusion Assessment Method.
The new 36-second method is comprised of two questions and has a success rate of 93 percent.
“We started by looking for one question that could detect delirium, but we could only get 83 percent sensitivity, which is not good enough,” Fick said.
Specifically this test asks patients the day of the week and then to say the months of the year in reverse order. If your patient fails to answer these two questions correctly, it is a sign of delirium.
The scientists double-checked the accuracy of the new method with the 3-D CAM method. While the two-question method is not foolproof yet, it shows enough promise that researchers are continuing research on this test.
How do you test for delirium in your patients when working as a travel nurse? Does this seem like a method you would use in your hospitals to gauge delirium in your patients?