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Found 15 results
  1. Content Article
    Studies from medical and surgical intensive care units (ICU) suggest that long-term outcomes are poor for patients who have spent significant time in an ICU. This study in the American Journal of Surgery aimed to identify determinants of post-intensive care physical and mental health outcomes 6–12 months after injury. The authors found that: Delirium during an intensive care unit (ICU) stay is linked with long-term physical impairment in injury survivors who spent three or more days in the ICU. The use of ventilators in the ICU is another factor associated with long-term physical impairment and mental health symptoms in these patients. Delirium and ventilator use are potentially modifiable, suggesting opportunities for improving patient outcomes. They suggest that that this knowledge can inform the development of interventions that specifically target delirium and ventilator use to mitigate long-term impairments.
  2. Content Article
    Emergence delirium is a temporary but potentially dangerous condition that can occur when a patient awakens after a procedure. In this video, staff at the VA Pittsburgh Healthcare System (VAPHS) share how they implemented a perioperative intervention to reduce the risk of patient and staff harm.
  3. News Article
    Patients needing emergency treatment are becoming sicker in A&E as hospitals struggle to free up enough beds, top doctors have warned. Dr Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), told The Independent that elderly patients are waiting so long for treatment in A&E that they’re developing bed sores and delirium. Another senior NHS doctor, Dr Vicky Price, who is president-elect of the Society for Acute Medicine, warned that corridor care is now “routine practice” with the situation only set to worsen as A&E departments come under increasing pressure. Their comments highlight the ongoing chaos in emergency medicine, as strikes take place during the most difficult time of the year. The chief executive of the NHS, Amanda Pritchard, said on Thursday that last winter was the worst she’d ever seen for the health service, warning that strikes by junior doctors will only make the situation harder for hospitals this year The warnings come as the latest NHS data shows that the prime minister, Rishi Sunak, could fail in his promise to deliver 5,000 more acute hospital beds to the NHS this month. Current data shows that the NHS is falling short of the target by just under 1,200 beds, with 97,818 against a target of 99,000. Read full story Source: The Independent, 10 November 2023
  4. Content Article
    In this video, William Pileggi, a registered nurse anaesthetist, discusses the implementation of the Golden Eagle Project at the VA Pittsburgh Healthcare System to improve outcomes for veterans who may be prone to experiencing post-operative emergent delirium. Through assessments to prescreen for PTSD, staff training and using alternative drug therapies, his hospital has had zero injury events related to emergent delirium since 2018. With minor modifications, the program is replicable at civilian hospitals.
  5. News Article
    Delirium and confusion may be common among some seriously-ill hospital patients with COVID-19, a study in The Lancet suggests. Long stays in intensive care and being ventilated are thought to increase the risk, the researchers say. Doctors should look out for depression, anxiety and post-traumatic stress disorder (PTSD) after recovery, although most patients, particularly those with mild symptoms, will not be affected by mental health problems. The evidence is based on studies of patients with severe acute respiratory syndrome (Sars) and Middle-East respiratory syndrome (Mers), as well early data on COVID-19 patients. Read full story Source: BBC News, 19 May 2020
  6. Content Article
    'This is me' is a simple leaflet for anyone receiving professional care who is living with dementia or experiencing delirium or other communication difficulties. 'This is me' can be used to record details about a person who can't easily share information about themselves. For example, it can be used to record: a person’s cultural and family background important events, people and places from their life their preferences and routines.
  7. Content Article
    The 21 September 2021 marks World Alzheimer’s Day. This is an international campaign to raise awareness and highlight issues faced by people affected by dementia (dementia is an umbrella term for a number of diseases that affect the brain, with Alzheimer’s disease its most common cause). In this interview, Patient Safety Learning speaks to Alison Keizer, a Mental Health Nurse and trust-wide Dementia Lead, and Fran Hamilton, Occupational Therapist and Deputy Dementia Lead, at Sussex Community NHS Foundation Trust, about the patient safety issues affecting patients with dementia and how they can be supported to reduce risk.
  8. Content Article
    This study in the British Journal of General Practice looked at the association between continuity of GP care and potentially inappropriate prescribing in patients with dementia, as well as the incidence of adverse health outcomes. The study authors found that for patients with dementia, consulting with the same doctor consistently, resulted in: 35% less risk of delirium 58% less risk of incontinence 10% less risk in emergency admission to hospital less inappropriate prescribing. The results demonstrate that increasing continuity of care for patients with dementia could improve their treatment and outcomes.
  9. Content Article
    Delirium is a common but underdiagnosed state of disturbed attention and cognition that afflicts one in four older hospital inpatients. It is independently associated with a longer length of hospital stay, mortality, accelerated cognitive decline and new-onset dementia. Risk stratification models enable clinicians to identify patients at high risk of an adverse event and intervene where appropriate. The advent of wearables, genomics, and dynamic datasets within electronic health records (EHRs) provides big data to which machine learning (ML) can be applied to individualise clinical risk prediction. ML is a subset of artificial intelligence that uses advanced computer programmes to learn patterns and associations within large datasets and develop models (or algorithms), which can then be applied to new data in rapidly producing predictions or classifications, including diagnoses. The objectives of this review from Strating et al. were to: (1) provide a more contemporary overview of research on all ML delirium prediction models designed for use in the inpatient setting; (2) characterise them according to their stage of development, validation and deployment; and (3) assess the extent to which their performance and utility in clinical practice have been evaluated.
  10. News Article
    Doctors and carers should look out for signs of confusion or strange behaviour in frail older people because it could be an early warning sign of COVID-19, research suggests. Even if they have no cough or fever, delirium is more common in vulnerable over-65s than other, fitter people of the same age. But it's not yet clear why this extreme confusion or delirium happens. In this King's College London study, data from more than 800 people over the age of 65 was analysed. They included 322 patients in hospital with COVID-19, and 535 people using the Covid Symptom Study app to record their symptoms or log health reports on behalf of friends and family. All had received a positive test result. The researchers found that older adults admitted to hospital who were classified as frail were more likely to have had delirium as one of their symptoms, compared with people of the same age who weren't frail. For one in five patients in hospital with Covid, delirium was their only symptom. The study calls for more awareness of it in hospitals and care homes. Read full story Source: BBC News, 30 September 2020
  11. Content Article
    This is the first study, published in Age and Ageing, demonstrating higher prevalence of probable delirium as a COVID-19 symptom in older adults with frailty compared to other older adults. This emphasises need for systematic frailty assessment and screening for delirium in acutely ill older patients in hospital and community settings. Clinicians should suspect COVID-19 in frail adults with delirium.
  12. Content Article
    Delirium is a common syndrome in hospitalized adults, particularly those age 65 or older, and has been recognized as a hospital-acquired condition that can result in serious harm to patients. Risk for developing delirium is influenced by predisposing and precipitating factors, many of which are modifiable. Hospitals are encouraged to implement an interdisciplinary, multicomponent delirium prevention plan targeted to these contributing factors to improve clinical outcomes and decrease harm. The Patient Safety Authority has collated guidelines, tools and resources on delirium.
  13. Content Article
    Delirium is among the most common of medical emergencies. Prevalence is around 20% in adult acute general medical patients and higher in particular clinical groups, such as patients in intensive care units. It affects up to 50% of those who have hip fracture and up to 75% in intensive care. Preventative measures can reduce the incidence of delirium.
  14. Content Article
    To extend the ICU Steps patient information guide, they have produced a series of information sheets on issues relevant to recovering intensive care patients. These documents are exclusively available online. They're free to download in PDF format for you to print, photocopy and distribute as needed. Topics include: Acquired brain injury and intensive care Breathing and critical illness Delirium and intensive care Looking after yourself after critical illness Medical tests in intensive care Planned treatment on the intensive care Tracheostomy in intensive care.
  15. Content Article
    Between 2009 and 2010, 48 year-old David Richards was admitted to intensive care during the ‘swine flu pandemic’. He spent six weeks in an intensive care unit (ICU), first on mechanical ventilation and later receiving extra-corporeal membrane oxygenation (ECMO) treatment. He recovered and became a survivor of severe acute respiratory distress syndrome (ARDS). During his 50 days in intensive care, David's former partner Rose kept an ‘ICU diary’. Rose recorded clinical updates as well as conversations with relatives and staff who were by David's bedside. In this article, David describes how important this diary has been to him understanding and processing his experience. It forms a record not just of procedures, treatments and clinical signs but of how he reacted, how he appeared to feel and how he tried to communicate during a time that were permeated by delirium.
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