Delirium

By

ACKNOWLEDGMENT

I would like to take this chance for thanking my research facilitator, friends & family for support they provided & their belief in me as well as guidance they provided without which I would have never been able to do this research.

DECLARATION

I, (Your name), would like to declare that all contents included in this thesis/dissertation stand for my individual work without any aid, & this thesis/dissertation has not been submitted for any examination at academic as well as professional level previously. It is also representing my very own views & not essentially which are associated with university.

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ABSTRACT

Delirium is the most common complication associated with hospitalization of older adults with incidence of 25% to 60%. Delirium is responsible for approximately 17.5 million hospital days annually, yet nurses fail to recognize it as much as 70% of the time. The main aim of this research was to critically appraise the literature regarding early recognition of delirium in ICU, formulating conclusions and recommendations to practice. The research is based on secondary data collection. The data is extracted from various journals, articles and books. The research approach used is qualitative. The literature search revealed that delirium in the hospitalized elderly patient, particularly in ICU, is a prevalent geriatric syndrome which is under recognized and under diagnosed. Misdiagnosis of delirium often results in mismanagement and poor health outcomes, the older patient. It was also demonstrated with the help of literature review that there is a significant impact of early recognition of delirium in ICU and this could help in reducing the length of stay in ICU as well.The research revealed that many delirium assessment tools have been developed, but that in many cases the tools are too time consuming for acute care nurses to use, don't give a complete picture of the whole delirium phenomena, don't address functional and cognitive behaviour, and were not specifically developed for nursing professionals to use. The data clearly shows the impact that delirium can have on the ICU patient. This information should empower the nursing community to study this topic further and to develop strategies to assist the bedside nurse to overcome barriers and develop techniques to improve outcomes for our patients. The results of this study clearly show that nurses need additional education on delirium to correct their misconceptions and provide an accurate assessment to critically ill patients. Education will give them the tools that they need and help them base their practice on evidence not tradition. The first step to take will be the education of current nurse educators.

TABLE OF CONTENTS

ACKNOWLEDGMENTII

DECLARATIONIII

ABSTRACTIV

CHAPTER 01: INTRODUCTION1

The Problem2

Delirium Outcomes2

Aims and Objectives3

Aims - How to Achieve3

Structure of Dissertation4

CHAPTER 02: METHODS6

Methodology6

Background and Rationale7

Inclusion and Exclusion Criteria9

Literature Sources10

Literature Critique11

Authors12

Titles and Abstracts13

Ethical Considerations14

Purpose/Problem of Study14

Key Words15

Appraisal Framework15

CHAPTER 03: LITERATURE REVIEW16

Literature Review16

Hypotheses18

Operational Definitions18

Sample and Design20

Critique on Quantitative Research Approach21

Statistical Analysis23

Results24

Themes26

CHAPTER 04: DISCUSSION28

Psychosocial Impact28

Nursing Assessment30

Barriers to Delirium Assessment31

CHAPTER 05: REFLECTIONS34

Predisposing and Precipitating Factors for Delirium34

Prevalence of Delirium35

Evaluation of Delirium36

Assessment Methods36

Documenting Delirium37

Assessing and Diagnosing Delirium38

CHAPTER 06: CONCLUSION40

Implications for Nursing40

Implications for Future Research42

REFERENCES43

Literature Sources51

BIBLIOGRAPHY54

APPENDIX61

CHAPTER 01: INTRODUCTION

Delirium is an ...