Quasi-experimental study on nursing interventions in the assessment, management and prevention of acute confusional syndrome

e202310092

Authors

Keywords:

Delirium, Frail elderly, Orientation, Nurses, Employee performance appraisal, Evidence-based practice

Abstract

BACKGROUND // Acute confusional syndrome (ACS) is one of the complications with the highest morbidity and mortality in hospitalization units, but it is a reversible situation if detected early, representing a clear challenge for nursing. The objectives of this study were to assess the interventions carried out by nurses for the identification and non-pharmacological preventive measures applied in acute confusional syndrome and relate them to the years of professional experience and training received.
METHODS // A quasi-experimental, prospective and analytical study was carried out through a self-administered structured questionnaire pre-post intervention (extracted from the JBI PACES program-Practical Application of Clinical Evidence System) on the identification and preventive measures applied in ACS. A total of 520 questionnaires (pre and post assessment) were distributed to nurses from the emergency department and the internal medicine unit of the Miguel Servet University Hospital in Zaragoza (Aragón, Spain) from January 2021 to April 2022. Statistical analysis carried out with the program Jamovi® 2.3.13.
RESULTS // 180 correctly completed questionnaires (94 pre and 86 post) were received. For 100%, the ACS supposed an extra workload and significant differences were found between the ability to manage ACS with the years of professional experience (p=<0.028). 97.2% of the nurses applied non-pharmacological interventions.
CONCLUSIONS // Despite being perceived as an extra burden in daily work, nurses perform non-pharmacological prevention for the management of ACS. It is necessary to improve training to provide guidance strategies.

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References

American Psychiatric A. DSM-5: Manual diagnóstico y estadístico de los trastornos mentales. Madrid: Editorial Médica Panamericana; 2014.

TM. JBI Evidence Summary. JBI Connect+. Delirium (Adults): Risk Screening, Assessment and Management. JBI; 2019 [Disponible en: connect.jbiconnectplus.org/ViewDocument.aspx?0=21433].

Han JH, Suyama J. Delirium and Dementia. Clin Geriatr Med. 2018;34(3):327-354(1879-8853 [Electrónico]).

Méndez Brich M, Morón Carande N, Casarramona Lobera F, Martín Martínez A, Martos Gutiérrez JA, Cristòfol Allué R et al. Impacto de la intervención geriátrica en el paciente anciano en urgencias. Revista Española de Geriatría y Gerontología. 2018;53:46-47.

Alamri SH, Ashanqity OA, Alshomrani AB, Elmasri AH, Saeed MB, Yahya SA et al. Delirium and correlates of delirium among newly admitted elderly patients: a cross-sectional study in a Saudi general hospital. Ann Saudi Med. 2018;38(1):15-21.

Warnier RMJ, Van Rossum E, Du Moulin M, van Lottum M, Schols J, Kempen G. The opinions and experiences of nurses on frailty screening among older hospitalized patients. An exploratory study. BMC Geriatr. 2021;21(1):624.

Marcantonio ER. Delirium in Hospitalized Older Adults. (1533-4406 [Electrónico]).

Gómez-Traveso T, Briongos-Figuero LS, Hernanz Román L, Pérez-Castrillón JL. [Assessment of acute confusional syndrome in elderly patients admitted to an internal medicine ward]. Rev Esp Geriatr Gerontol. 2013;48(2):95-96.

Quispel-Aggenbach DA-O, Schep-de Ruiter EPR, Van Bergen W, Bolling JR, Zuidema SU, Luijendijk HJ. Prevalence and risk factors of delirium in psychogeriatric outpatients. (1099-1166 [Electrónico]).

Lafarga Molina L, Gallardo-Doñate P, Bueno-Pros C, Casanovas-Marsal J-O, González de la Cuesta D. Evolución del Síndrome Confusional Agudo durante las primeras 24 horas de ingreso en Medicina Interna. Presencia. 2022;18.

Van Velthuijsen EL, Zwakhalen SMG, Mulder WJ, Verhey FRJ, Kempen G. Detecting and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice. (1099-1166 [Electrónico]).

Green JR, Smith J, Teale E, Collinson M, Avidan MS, Schmitt EM et al. Use of the confusion assessment method in multicentre delirium trials: training and standardisation. BMC Geriatr. 2019;19(1):107.

Gorski S, Piotrowicz K, Rewiuk K, Halicka M, Kalwak W, Rybak P et al. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study. Biomed Res Int. 2017;2017:1297164.

Piotrowicz K, Rewiuk K, Górski S, Kałwak W, Wizner B, Pac A et al. The “Wholesome Contact” non-pharmacological, volunteer-delivered multidisciplinary programme to prevent hospital delirium in elderly patients: study protocol for a randomised controlled trial. Trials. 2018;19(1):439.

Abraha I, Trotta F, Rimland JM, Cruz-Jentoft A, Lozano-Montoya I, Soiza RL et al. Efficacy of Non-Pharmacological Interventions to Prevent and Treat Delirium in Older Patients: A Systematic Overview. The SENATOR project ONTOP Series. PLoS One. 2015;10(6):e0123090.

Mossello E, Lucchini F, Tesi F, Rasero L. Family and healthcare staff’s perception of delirium. Eur Geriatr Med. 2020;11(1):95-103.

Schmitt EM, Gallagher J, Albuquerque A, Tabloski P, Lee HJ, Gleason L et al. Perspectives on the Delirium Experience and Its Burden: Common Themes Among Older Patients, Their Family Caregivers, and Nurses. Gerontologist. 2019;59(2):327-337.

JBI web. JBI. 2023 [Disponible en: https://jbi.global/].

Institute JBI. JBI PACES 2023 [Disponible en: https://paces.jbi.global/].

JBI PACES Introduction and welcome to PACES program. PACEsetterS. 2005;2(1):10-25.

Lim XM, Lim ZHT, Ignacio J. Nurses’ experiences in the management of delirium among older persons in acute care ward settings: A qualitative systematic review and meta-aggregation. Int J Nurs Stud. 2022;127:104157.

Martins SA-O, Pinho E, Correia R, Moreira E, Lopes L, Paiva JA et al. What effect does delirium have on family and nurses of older adult patients? (1364-6915 [Electrónico]).

Melguizo-Herrera E, Acosta-López A, Gómez-Palencia IP, Manrique-Anaya Y, Hueso-Montoro C. The Design and validation of a Nursing Plan for Elderly Patients with Postoperative Delirium. Int J Environ Res Public Health. 2019;16(22).

Travers C, Henderson A, Graham F, Beattie E. CogChamps: impact of a project to educate nurses about delirium and improve the quality of care for hospitalized patients with cognitive impairment. (1472-6963 [Electrónico]).

Husser EK, Fick DA-O, Boltz MA-O, Shrestha PA-OX, Siuta J, Malloy S et al. Implementing a Rapid, Two-Step Delirium Screening Protocol in Acute Care: Barriers and Facilitators. (1532-5415 [Electrónico]).

Solà-Miravete EA-O, López C, Martínez-Segura E, Adell-Lleixà M, Juvé-Udina ME, Lleixà-Fortuño M. Nursing assessment as an effective tool for the identification of delirium risk in older in-patients: A case-control study. (1365-2702 [Electrónico]).

Silva RCGd, Silva AAdP, Marques PAO. Análisis de registros producidos por el equipo de salud y de la percepción de los enfermeros sobre las señales y síntomas de delirio. Revista Latino-Americana de Enfermagem. 2011;19:81-89.

Helgesen AK, Adan YH, Dybvik Bjørglund C, Weberg-Haugen C, Johannessen M, Åsmul Kristiansen K et al. Nurses’ experiences of delirium and how to identify delirium-A qualitative study. Nurs Open. 2021;8(2):844-849.

Inouye SK, Inouye K. The Confusion Assessment Method (CAM): training manual and coding guide. 2003.

Xing J, Sun Y, Jie Y, Yuan Z, Liu W. Perceptions, attitudes, and current practices regards delirium in China: A survey of 917 critical care nurses and physicians in China. Medicine (Baltimore). 2017;96(39):e8028.

Ministerio de Sanidad (España). Actualización del documento de consenso sobre la prevención de la fragilidad en la persona mayor. Madrid: Gobierno de España; 2022.

Published

2023-10-31

How to Cite

1.
Lafarga-Molina L, Casanovas-Marsal J-O, González de la Cuesta D. Quasi-experimental study on nursing interventions in the assessment, management and prevention of acute confusional syndrome: e202310092. Rev Esp Salud Pública [Internet]. 2023 Oct. 31 [cited 2024 Nov. 21];97:11 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/172

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