Korean J Adult Nurs.  2014 Feb;26(1):89-97. 10.7475/kjan.2014.26.1.89.

Effects of Nursing Intervention Program on Reducing Acute Confusion in Hospitalized Older Adults

Affiliations
  • 1Sunlin Hospital, Pohang, Korea.
  • 2College of Nursing, Keiymyung University, Daegu, Korea. yshin@kmu.ac.kr

Abstract

PURPOSE
During hospitalization, confusion occurs in 15~20% of older adults and persists in 5~10% of them. This study was designed to investigate effects of a five-day nursing intervention program designed to reduce confusion in hospitalized older adults. Subjects were inpatients over the age of 60 years old and were admitted in a surgical care unit.
METHODS
Data were collected from 111 patients. Subjects divided into one of two groups, 58 patients of the control group which received the usual nursing care; and 53 patients of the intervention group which received the usual nursing care plus nursing intervention program for reducing acute confusion. The Delirium Observation Screening Scale (DOS) and the Korean Mini-Mental Screening Examination (MMSE-K) were utilized.
RESULTS
1) Acute delirium was significantly reduced in the intervention group compared to the control group (chi2=4.22, p=.034) as well as the duration of the delirious state was significantly shortened (F=56.62, p<.001). Cognitive function of the intervention group was improved (F=21.14, p<.001).
CONCLUSION
The nursing intervention program reduced the incidence and duration of acute delirium of the elderly inpatients, as well as it helps them keep better cognitive function than the control group.


MeSH Terms

Adult*
Aged
Delirium
Hospitalization
Humans
Incidence
Inpatients
Mass Screening
Nursing Care
Nursing*

Reference

1. Balas MC, Rice M, Chaperon C, Smith H, Fuchs B. Management of delirium in critically ill older adults. Crit Care Nurse. 2012; 32(4):DOI: 10.4037/ccn2012480. Retrieved May 3, 2013, from http://ccn.aacnjournals.org.
Article
2. Beresin EV. Delirium in the elderly. J Geriatr Psychiatry Neurol. 1988; 1:127–143.
Article
3. Cole MG, McCusker JJ. Treatment of delirium in older medical inpatients: a challenge for geriatric specialists. J Am Geriatr Soc. 2002; 50(12):2101–2103.
Article
4. Cole MG, Primeau FJ, Bailey RF, Bonnycastle MJ, masciarelli F, Engelsmann , et al. Systematic intervention for elderly inpatients with delirium: a randomized trial. CMAJ. 1994; 151(7):965–970.
5. Elie M, Rousseau F, Cole M, Primeau F, McCusker J, Bellayance F. Prevalence and detection of delirium in elderly emergency department patients. CMAJ. 2000; 163(8):977–981.
6. Ely EW, Siegel MD, Iouye SK. Delirium in the intensive care unit: An under-recognized syndrome of organ dysfunction. Semin Respir Crit Care Med. 2001; 22(2):115–126.
Article
7. Engelberger S, Zürcher M, Schuld J, Viehl CT, Kettelhack C. Postoperative course after emergency colorectal surgery for secondary peritonitis in the elderly is often complicated by delirium. Int Surg. 2012; 97(2):129–134. DOI: 10.9738/CC125.1.
Article
8. Folstein MF, Folstein SE, McHugh PR. "Mini-mental." state A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189–198.
9. Francis J, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. JAMA. 1990; 263(8):1097–1101.
Article
10. Hwang SW, Kang SW, Kang YG, Choi SG, Lee J, Kim MJ, et al. Risk factors of delirium in elderly inpatients. J Korean Acad Fam Med. 2002; 23(1):112–121.
11. Inouye SK. Delirium in hospitalized older patients. Clin Geriatr Med. 1998; 14(4):745–764.
Article
12. Inouye SK. Delirium in hospitalized older patients: Recognition and risk factor. J Geriatr Psychiatry Neurol. 1998; 11(3):118–125.
13. Inouye SK, Borgadus ST, Charpentier PA, Leo-Summers L, Acapora D, Holford TR, et al. A multicomponent interventions to prevent delirium in hospitalized older patients. N Engl J Med. 1999; 340:669–676.
14. Justic M. Does "ICU psychosis" really exist? Crit Care Nurse. 2000; 20(3):28–37.
Article
15. Kim HY, Park MS, Lee HJ. The effects of delirium prevention education on hospitalized elders at high risk for delirium. J Korean Gerontol Nurs. 2007; 9(1):60–67.
16. Kwon YC, Park JH. A research for standardization of Korean Mini Mental State Examination for elderly. J Korean Neuropsychiatr Assoc. 1989; 28(1):125–131.
17. Lipowski ZJ. Update on delirium. Psychiatr Clin North Am. 1992; 15(2):335–346.
Article
18. Marcantonio ER, Goldman L, Orav EJ, Cook EF, Lee TH. The association of intraoperative factor with development of postoperative delirium. Am J Med. 1998; 105(5):380–384.
19. McNicoll L, Pisani MA, Zhang Y, Ely EW, Siegel MD, Inouye SK. Delirium in the intensive care unit: Occurrence and clinical course in older patients. J Am Geriatr Soc. 2003; 51(5):591–598.
Article
20. Rizzo JA, Bogardus ST Jr, Leo-Summers L, Williams CS, Acampora D, Inouye SK. Multicomponent targeted intervention to prevent delirium in hospitalized older patients: What is the economic value? Med Care. 2001; 39(7):740–752.
21. Schuurmans MJ, Donders RT, Duursma SA. Delirium case finding: Pilot testing of a new screening scale for nurses. J Am Geriatr Soc. 2002; 50:suppl A8. S3.
22. Schuurmans MJ, Shortridge-Bagget LM, Duursma SA. The Delirium Observation Screening Scale: A screening instrument for delirium. Res Theory Nurs Pract. 2003; 17:31–50. DOI: 10.1891/rtnp.17.1.31.53169.
Article
23. Wanich CK, Sullivan-Max EM, Gottlieb GL, Johnson JC. Functional status outcomes of a nursing intervention in hospitalized elderly. Image J Nurs Sch. 1992; 24(3):201–207.
Article
24. Yoo MY. Related factor of delirium occurrence in the intensive care unit patients. Ajou University;2007. Unpublished master's thesis.
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