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Delirium in Long Term Care Rehabilitation Residents: A Correlational Retrospective Study.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Delirium in Long Term Care Rehabilitation Residents: A Correlational Retrospective Study./
作者:	Lerma-Kjonegaard, Rebecca.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
面頁冊數:	120 p.
附註:	Source: Dissertations Abstracts International, Volume: 81-04, Section: B.
Contained By:	Dissertations Abstracts International81-04B.
標題:	Nursing. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13886013
ISBN:	9781085774918

Delirium in Long Term Care Rehabilitation Residents: A Correlational Retrospective Study.
Lerma-Kjonegaard, Rebecca.

Delirium in Long Term Care Rehabilitation Residents: A Correlational Retrospective Study. - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 120 p.

Source: Dissertations Abstracts International, Volume: 81-04, Section: B.

Thesis (Ph.D.)--University of San Diego, 2019.

This item is not available from ProQuest Dissertations & Theses.

Background: Delirium is associated with devastating outcomes, cognitive loss, decreased function and an increase risk of mortality which affects patients and places a heavy burden on family and the healthcare system. The purpose of this study was to describe the relationship between select demographics, clinical characteristics, CHART-DEL-derived delirium diagnosis and ICD-10 coded discharge delirium diagnoses among Long Term Care (LTC) rehabilitation residents.Method: A retrospective correlational design from174 LTC rehabilitation residents age 65 years or older using EMR and hard copy charts. The setting was a Southern California community hospital-based 100-bed LTC. Abstracted data included demographic characteristics (age, gender, race), principal admitting diagnosis, admission source, discharge disposition, medication management (polypharmacy, psychotropic medications duration), presence of dementia, CHART-DEL-derived delirium diagnoses documented delirium symptoms and International Classification of Disease, 10th revision (ICD 10) coded delirium, LOS, Charlson score (comorbidities). Statistical methodology included: descriptive statistics for demographic and other variable data. Chi square for relationship between delirium and the independent variables. ANOVA described the difference between the variables. Multiple logistic regression determined the odds of having a delirium diagnosis (by either approach with separate models) based upon gender, race, principle admitting diagnosis, polypharmacy, dementia, age, LOS, Charlson score (comorbidities), and psychotropic medications duration.Results: Majority residents were female, white, average age 80.6, 99.4% acute care admissions, and 96.6% had polypharmacy. Psychotropic duration mean was 9.5 days, LOS 14.7 days, and 64.9% discharged home with home health. More delirium identified with CHART-DEL-derived delirium diagnoses (24.9%) compared to ICD-10 code diagnosis (5.2%). The Charlson score (comorbidity) was related to delirium in both models (CHART-DEL-derived p = .044; ICD-10 code p = .002), while LOS additionally explained variance, but only in CHART-DEL-derived delirium model.Conclusions: The daily use of a delirium-screening instrument by the healthcare team could assist with delirium identification sooner and implement appropriate interventions. This then could decrease negative outcomes of delirium, improve satisfaction among family and staff and increase resident quality of care and safety.

ISBN: 9781085774918Subjects--Topical Terms:

528444
Nursing.
Subjects--Index Terms:

Cognitive impairment

Delirium in Long Term Care Rehabilitation Residents: A Correlational Retrospective Study.
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520 $a Background: Delirium is associated with devastating outcomes, cognitive loss, decreased function and an increase risk of mortality which affects patients and places a heavy burden on family and the healthcare system. The purpose of this study was to describe the relationship between select demographics, clinical characteristics, CHART-DEL-derived delirium diagnosis and ICD-10 coded discharge delirium diagnoses among Long Term Care (LTC) rehabilitation residents.Method: A retrospective correlational design from174 LTC rehabilitation residents age 65 years or older using EMR and hard copy charts. The setting was a Southern California community hospital-based 100-bed LTC. Abstracted data included demographic characteristics (age, gender, race), principal admitting diagnosis, admission source, discharge disposition, medication management (polypharmacy, psychotropic medications duration), presence of dementia, CHART-DEL-derived delirium diagnoses documented delirium symptoms and International Classification of Disease, 10th revision (ICD 10) coded delirium, LOS, Charlson score (comorbidities). Statistical methodology included: descriptive statistics for demographic and other variable data. Chi square for relationship between delirium and the independent variables. ANOVA described the difference between the variables. Multiple logistic regression determined the odds of having a delirium diagnosis (by either approach with separate models) based upon gender, race, principle admitting diagnosis, polypharmacy, dementia, age, LOS, Charlson score (comorbidities), and psychotropic medications duration.Results: Majority residents were female, white, average age 80.6, 99.4% acute care admissions, and 96.6% had polypharmacy. Psychotropic duration mean was 9.5 days, LOS 14.7 days, and 64.9% discharged home with home health. More delirium identified with CHART-DEL-derived delirium diagnoses (24.9%) compared to ICD-10 code diagnosis (5.2%). The Charlson score (comorbidity) was related to delirium in both models (CHART-DEL-derived p = .044; ICD-10 code p = .002), while LOS additionally explained variance, but only in CHART-DEL-derived delirium model.Conclusions: The daily use of a delirium-screening instrument by the healthcare team could assist with delirium identification sooner and implement appropriate interventions. This then could decrease negative outcomes of delirium, improve satisfaction among family and staff and increase resident quality of care and safety.
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