Original StudyDocumentation and Management of Words Associated With Delirium Among Elderly Patients in Postacute Care: A Pilot Investigation
Section snippets
Methods
The design was a retrospective electronic and paper chart-based review study. Potential participants were patients admitted to 2 postacute facilities affiliated with Vanderbilt University Medical Center, Nashville, TN, from March 1, 2007, through March 31, 2008. An electronic search through the charts looking for 10 keywords associated with delirium, as previously validated in a chart-based review for delirium identification11 (ie, confusion, disorientation, altered mental status, delirium,
Results
A total of 92 (10%) patients of 895 charts reviewed were identified whose charts contained keywords suggestive of delirium. Twelve of these patients were excluded for severe dementia and hence prevalence of keywords associated with delirium for patients not severely demented was estimated to be 9% (80 patients). The characteristics of the population are described in Table 1. Among 80 patients included in the study 44% had a high school education. Almost half of the studied population (44%) had
Discussion
Health care providers (primarily nurses) described patient behaviors in the chart that are potentially associated with delirium in 9% of PAC patient charts who were not severely cognitively impaired but seldom used the term delirium. The term confusion was used in 95% of the cases to describe mental status when any word to describe mental status was used, whereas the term delirium was used in 7% of the cases when a descriptive word was provided in the chart. The patients in the “action-taken”
Acknowledgments
The authors acknowledge with gratitude Nona Cooper, Brenda Ray, Melinda Newell, and Jamie Spicer, GNP, for the great support in accessing the electronic and paper charts.
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Dr. Ely has received research grants from the National Institute of Health. (AG027472-01A1) and VA-Meritgrant. The other authors report no financial disclosures.