Steis Melinda R, Behrens Liza, Colancecco Elise M, Mogle Jacqueline, Mulhall Paula M, Hill Nikki L, Fick Donna M, Kolankowski Ann M
Integrated Health Services, Orlando Veterans Administration Medical Center, Viera, FL.
College of Nursing, The Pennsylvania State University, University Park, PA.
Ann Longterm Care. 2015 Oct;23(10):15-20. Epub 2015 Oct 28.
Many nursing home residents experience delirium. Nursing home personnel, especially nursing assistants, have the opportunity to become familiar with residents' normal cognitive function and to recognize changes in a resident's cognitive function over time. The purpose of this study was to determine the accuracy of delirium recognition by licensed nurses and nursing assistants from eight nursing homes over a 12-month period. Participants were asked to complete five case vignette assessments at three different time points (in 6-month intervals) to test their ability to identify different subtypes of delirium and delirium superimposed on dementia (DSD). A total of 760 case vignettes were completed across the different time points. Findings reveal that staff recognition of delirium was poor. The case vignette describing hyperactive DSD was correctly identified by the greatest number participants, and the case vignette describing hypoactive DSD was correctly identified by the least number of participants. Recognition of the case vignette describing hypoactive delirium improved over time. Nursing assistants performed similarly to the licensed nurses, indicating that all licensed nursing home staff require further education to correctly recognize delirium in older adults.
许多养老院居民会出现谵妄。养老院工作人员，尤其是护理助理，有机会熟悉居民的正常认知功能，并随着时间推移识别居民认知功能的变化。本研究的目的是确定八家养老院的执业护士和护理助理在12个月期间对谵妄识别的准确性。参与者被要求在三个不同时间点（间隔6个月）完成五项病例 vignette 评估，以测试他们识别不同谵妄亚型以及叠加在痴呆症上的谵妄（DSD）的能力。在不同时间点共完成了760个病例 vignette。研究结果显示，工作人员对谵妄的识别能力较差。描述多动型DSD的病例 vignette 被最多参与者正确识别，而描述少动型DSD的病例 vignette 被最少参与者正确识别。随着时间推移，对描述少动型谵妄的病例 vignette 的识别有所改善。护理助理的表现与执业护士相似，这表明所有养老院的执业工作人员都需要接受进一步教育，以正确识别老年人的谵妄。
