Cardiothoracic Critical Care, Essex Cardiothoracic Centre, Basildon Hospital, Basildon, Essex SS16 5NL, UK.
Nurs Crit Care. 2013 Jan-Feb;18(1):8-13. doi: 10.1111/j.1478-5153.2012.00514.x. Epub 2012 Jun 26.
To share an experience of introducing Delirium scoring into a Cardiothoracic Critical Care Unit and the lessons learnt.
Delirium has serious consequences leading to increased length of stay in hospital, the possible development of dementia with the associated need for long-term care and even death. It is therefore vital that the Critical Care nurses are able to prevent, recognize and manage delirium.
108 patients who were admitted over a 6 week period were audited and their delirium score, documentation and treatment plans were reviewed.
21% of patients experienced delirium during their stay on Cardiothoracic Critical Care and hypoactive delirium was the most prevalent subtype. Of the three patients who stayed more than 20 days on critical care all suffered with delirium at some point during their stay. Documentation of delirium by both Nursing and Medical staff occurred in less than 50% of patients.
The introduction of delirium scoring and audit of its practice has highlighted the incidence of delirium in critically ill patients and has resulted in; Improved quality of care by development of a delirium care bundle Improved recognition of delirium Instigation of practices to prevent and treat delirium.
分享将谵妄评分引入心胸重症监护病房的经验及所得到的教训。
谵妄可导致住院时间延长、痴呆的发生风险增加以及长期护理的需求，甚至死亡，因此重症监护护士能够预防、识别和处理谵妄至关重要。
对在 6 周内入院的 108 例患者进行了审核，并对其谵妄评分、记录和治疗计划进行了回顾。
21%的患者在心胸重症监护期间出现谵妄，且以低活动型谵妄最为常见。在入住重症监护超过 20 天的 3 例患者中，均在入住期间的某个时间点出现了谵妄。护理人员和医务人员对谵妄的记录不足 50%。
引入谵妄评分并对其应用进行审核，突出了危重症患者中谵妄的发生率，并由此带来了以下改善：制定了谵妄护理包，提高了护理质量；提高了对谵妄的识别能力；制定了预防和治疗谵妄的措施。
