Durst Jennifer, Wilson Denise
Mennonite College of Nursing at Illinois State University, Normal, IL, USA; Carle Hospital, Urbana, IL, USA.
Mennonite College of Nursing at Illinois State University, Normal, IL, USA.
Int J Orthop Trauma Nurs. 2020 Feb;36:100710. doi: 10.1016/j.ijotn.2019.100710. Epub 2019 Aug 1.
Delirium is a sudden change of consciousness experienced by hospitalized patients that results in negative outcomes. The incidence of delirium is under-reported and can be prevented in many patients. The purpose of this evidence-based study was to determine if the incidence of delirium decreased with the use of prevention interventions for hip fracture patients.
The project was a prospective quality improvement project. An audit of medical records using the CHART-DEL instrument was conducted pre- and post-implementation of an evidence-based protocol. Medical records were reviewed until discharge for the use of prevention interventions and the diagnosis of delirium.
The sample included 90 hip fracture patients, 45 patients in both the pre- and post-implementation groups. The hip fracture protocol was used by admitting physicians in 31% of admissions and prevention interventions were documented by nurses in 75.6% of medical records. The incidence of delirium was similar in both groups; 11.1% in the pre-implementation group and 15.6% in the post-implementation group and was not statistically significant.
Healthcare workers should take measures to reduce the incidence of delirium. There is a need for further studies on the use of protocols in the identification, prevention, and treatment of delirium in hospitalized patients.
谵妄是住院患者经历的意识突然改变，会导致不良后果。谵妄的发病率报告不足，且在许多患者中是可以预防的。这项循证研究的目的是确定谵妄的发病率是否会因对髋部骨折患者采取预防干预措施而降低。
该项目是一项前瞻性质量改进项目。在实施循证方案前后，使用CHART-DEL工具对病历进行审核。对病历进行审查，直至患者出院，以查看预防干预措施的使用情况和谵妄的诊断情况。
样本包括90名髋部骨折患者，实施前后两组各有45名患者。31%的入院患者中，收治医生使用了髋部骨折方案，75.6%的病历中有护士记录的预防干预措施。两组谵妄的发病率相似；实施前组为11.1%，实施后组为15.6%，差异无统计学意义。
医护人员应采取措施降低谵妄的发病率。有必要进一步研究在住院患者谵妄的识别、预防和治疗中使用方案的情况。
