Kennedy Maura, Webb Margaret, Gartaganis Sarah, Hwang Ula, Biese Kevin, Stuck Amy, Lesser Adriane, Hshieh Tammy, Inouye Sharon K
Department of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USA.
Department of Emergency Medicine Harvard Medical School Boston Massachusetts USA.
J Am Coll Emerg Physicians Open. 2021 Apr 29;2(2):e12421. doi: 10.1002/emp2.12421. eCollection 2021 Apr.
Delirium is a common and deadly problem in the emergency department affecting up to 30% of older adult patients. The 2013 Geriatric Emergency Department guidelines were developed to address the unique needs of the growing older population and identified delirium as a high priority area. The emergency department (ED) environment presents unique challenges for the identification and management of delirium, including patient crowding, time pressures, competing priorities, variable patient acuity, and limitations in available patient information. Accordingly, protocols developed for inpatient units may not be appropriate for use in the ED setting. We created a Delirium Change Package and Toolkit in the Emergency Department (ED-DEL) to provide protocols and guidance for implementing a delirium program in the ED setting. This article describes the multistep process by which the ED-DEL program was created and the key components of the program. Our ultimate goal is to create a resource that can be disseminated widely and used to improve delirium identification, prevention, and management in older adults in the ED.
谵妄是急诊科常见且致命的问题，影响高达30%的老年患者。2013年老年急诊科指南旨在满足日益增长的老年人群的特殊需求，并将谵妄确定为高度优先领域。急诊科环境给谵妄的识别和管理带来了独特挑战，包括患者拥挤、时间压力、相互竞争的优先事项、患者病情严重程度不一以及可用患者信息有限。因此，为住院病房制定的方案可能不适用于急诊科环境。我们创建了急诊科谵妄变更包和工具包（ED-DEL），以提供在急诊科环境中实施谵妄项目的方案和指导。本文描述了创建ED-DEL项目的多步骤过程以及该项目的关键组成部分。我们的最终目标是创建一种可广泛传播并用于改善急诊科老年患者谵妄识别、预防和管理的资源。
