护士在急性老年病房使用4AT进行谵妄筛查：一项质量改进项目的结果
Delirium screening in an acute geriatric ward by nurses using 4AT: results from a quality improvement project.
作者信息
Myrstad Marius, Watne Leiv O, Johnsen Nina T, Børs-Lind Emma, Neerland Bjørn E
机构信息
Department of Internal Medicine, Bærum Hospital Vestre Viken Trust, 1346, Gjettum, Norway.
Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital, 0424, Oslo, Norway.
出版信息
Eur Geriatr Med. 2019 Aug;10(4):667-671. doi: 10.1007/s41999-019-00215-y. Epub 2019 Jun 27.
METHODS
We conducted a retrospective chart-based analysis based on a quality improvement project in an acute geriatric ward. Delirium screening with the 4AT was performed by nurses within 24 h after hospital admission. Delirium according to DSM-5 criteria was diagnosed retrospectively based on review of patient records.
RESULTS
In total, 59 patients (mean age 86 years) were included. The prevalence of delirium was 36%. Two out of three patients recovered from their delirium within four days after onset. The sensitivity and specificity of the single-point assessment with 4AT performed by nurses were 50.0% [95% confidence interval (CI) 27.2-72.8] and 86.2% (95% CI 68.3-96.1).
CONCLUSION
Patients admitted to the acute geriatric ward had a high prevalence of delirium. The sensitivity of the 4AT performed by nurses for delirium was lower than in previous studies where it was undertaken by experienced geriatricians or delirium researchers.
方法
我们基于一项急性老年病房质量改进项目进行了一项回顾性图表分析。护士在患者入院后24小时内使用4AT进行谵妄筛查。根据DSM-5标准，通过回顾患者记录对谵妄进行回顾性诊断。
结果
共纳入59例患者（平均年龄86岁）。谵妄患病率为36%。三分之二的患者在谵妄发作后四天内康复。护士进行的4AT单点评估的敏感性和特异性分别为50.0%[95%置信区间（CI）27.2-72.8]和86.2%（95%CI 68.3-96.1）。
结论
入住急性老年病房的患者谵妄患病率较高。护士进行的4AT对谵妄的敏感性低于之前由经验丰富的老年病医生或谵妄研究人员进行的研究。
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