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    This document provides an overview of delirium in the acute care setting. It discusses that delirium affects up to 80% of mechanically ventilated patients and increases mortality, length of stay, and recovery time. The pathophysiology involves impairment of cerebral metabolism and neurotransmitter abnormalities. Risk factors include age over 65, cognitive impairment, comorbidities, infection, sensory impairment, immobilization, and medications. The Confusion Assessment Method is used for diagnosis. Therapies can help prevent and manage delirium through orientation, sleep hygiene, environmental modifications, early mobilization, and cognitive therapy. The Hospital Elder Life Program focuses on these areas and reduces delirium incidence by up to 30%.

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    This document provides an overview of delirium in the acute care setting. It discusses that delirium affects up to 80% of mechanically ventilated patients and increases mortality, length of stay, and recovery time. The pathophysiology involves impairment of cerebral metabolism and neurotransmitter abnormalities. Risk factors include age over 65, cognitive impairment, comorbidities, infection, sensory impairment, immobilization, and medications. The Confusion Assessment Method is used for diagnosis. Therapies can help prevent and manage delirium through orientation, sleep hygiene, environmental modifications, early mobilization, and cognitive therapy. The Hospital Elder Life Program focuses on these areas and reduces delirium incidence by up to 30%.

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    This document provides an overview of delirium in the acute care setting. It discusses that delirium affects up to 80% of mechanically ventilated patients and increases mortality, length of stay, and recovery time. The pathophysiology involves impairment of cerebral metabolism and neurotransmitter abnormalities. Risk factors include age over 65, cognitive impairment, comorbidities, infection, sensory impairment, immobilization, and medications. The Confusion Assessment Method is used for diagnosis. Therapies can help prevent and manage delirium through orientation, sleep hygiene, environmental modifications, early mobilization, and cognitive therapy. The Hospital Elder Life Program focuses on these areas and reduces delirium incidence by up to 30%.

    Copyright:

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    40 views13 pages

    In Service

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    api-412489828
    This document provides an overview of delirium in the acute care setting. It discusses that delirium affects up to 80% of mechanically ventilated patients and increases mortality, length of stay, and recovery time. The pathophysiology involves impairment of cerebral metabolism and neurotransmitter abnormalities. Risk factors include age over 65, cognitive impairment, comorbidities, infection, sensory impairment, immobilization, and medications. The Confusion Assessment Method is used for diagnosis. Therapies can help prevent and manage delirium through orientation, sleep hygiene, environmental modifications, early mobilization, and cognitive therapy. The Hospital Elder Life Program focuses on these areas and reduces delirium incidence by up to 30%.

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    of 13

    Delirium: Acute Care Setting

    Created by: Gabrielle Beauchamp, OTS


    Objectives
    • Overview of Delirium

    • Risk Factors

    • CAM assessment

    • Ways therapy can prevent or manage


    delirium in acute care setting
    What is Delirium?
    Why learn about Delirium?
    Hospitalized people who have delirium have a longer hospital stay,
    higher treatment costs, greater care dependency, increase mortality
    and a longer recovery time (cognitively and functionally) after they
    leave the hospital.

    Delirium affects up to 80% of mechanically ventilated patients and 5 to


    50% of older adults after surgery (perioperative cognitive decline).

    Each day a patient has delirium = 10% increase in risk of death.


    Experiences with Delirium
    in acute care?
    Pathophysiology
    Mechanisms are not fully understood but
    may involve

    ● Reversible impairment of cerebral


    oxidative metabolism
    ● Multiple neurotransmitter
    abnormalities
    ● Generation of cytokines

    Regardless of the cause, the cerebral


    hemispheres or arousal mechanisms of
    the thalamus and brain stem become
    impaired.
    Risk Factors
    Non-modifiable Potentially modifiable

    • Over the age of 65 • High-risk medications


    • Pre-existing cognitive impairment • Polypharmacy
    (dementia) • Immobility
    • Gender (males) • Sensory impairment
    • Comorbidities (hypertension, • Urinary catheterization
    depression, alcohol use) • Length of hospital stay
    • Severity of illness • Inadequately controlled pain
    • Infection • Sleep deprivation or disturbance
    • Hearing and/or visual impairment • Anemia
    • Recent coma • Hypoxia or hypercarbia
    • Prior institutionalization • Poor nutrition
    • Dehydration
    • Electrolyte abnormalities
    • Mechanical Ventilation
    Confusion Assessment Method (CAM)
    Diagnostic Criteria
    Therapies role in Delirium
    Prevention & Management

    Orientation Sleep Hygiene

    Environment Cognitive Therapy


    Sensory needs
    Clinical Parameters
    Early mobilization
    Hospital Elder Life
    Program (HELP)
    Research shows this is the most successful non-
    pharmacological program.

    More than 200 HELP sites in 32 states and 11


    counties; any hospital can join and get training

    Focuses on maintaining orientation to surroundings,


    nutrition, sleep and mobilization

    Up to 30% reduction of delirium


    Questions/Comments?

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