在中级护理病房实施谵妄筛查。

IF 0.2 Q4 NURSING
Christyn A Gaa, Bimbola F Akintade
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引用次数: 0

摘要

背景:多达 82% 的住院病人会出现谵妄。使用有效可靠的工具可以及早发现并进行管理,从而减轻不良影响,包括减少患者跌倒:开展一项质量改进项目,在中级护理病房实施混乱评估法(CAM)工具,并测量谵妄筛查的依从性、工具的可行性以及对报告的患者跌倒的影响:方法:采用 14 个项目的事前事中知识理解评估进行网络培训。CAM工具被添加到电子健康记录(EHR)中,并在八周内对文件记录的合规性进行测量。之后,发放护士感知调查表,并对干预前后 60 天的患者跌倒情况进行比较:结果:47 名护士完成了培训。测试后的平均分高于测试前(p = .16);有五个答案有明显改善(p < .02)。筛查和记录符合率为 79.1%。21 名护士完成了认知调查,表明她们一致认为谵妄 CAM 筛查是一项可行的干预措施。患者跌倒率降低了 57%:结论:在电子病历中加入 CAM 工具可提高筛查的依从性:对护理工作的启示:早期发现谵妄可减少患者跌倒。CAM是一种可行的工具,谵妄筛查是一种值得采取的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementing Delirium Screening in an Intermediate Care Unit.

Background: Delirium occurs in as many as 82% of hospitalized patients. Use of a valid and reliable tool allows for early detection and management to mitigate adverse effects, including a decrease in patient falls.

Objective: To conduct a quality improvement project to implement the confusion assessment method (CAM) tool in an intermediate care unit and measure delirium screening compliance, feasibility of the tool, and the effect on reported patient falls.

Methods: Web-based training using a 14-item pre-post assessment for knowledge comprehension. The CAM tool was added to the electronic health record (EHR), and documentation compliance was measured for eight weeks. Afterwards, a nurse perception survey was distributed, and 60-day pre- and post-intervention patient falls were compared.

Results: Forty-seven nurses completed the training. Post-test averages were higher than the pre-test (p = .16); five answers showed significant improvement (p < .02). Screening and documentation compliance were 79.1%. Twenty-one nurses completed the perception survey, demonstrating agreement that delirium CAM screening is a feasible intervention. Patient falls were reduced by 57%.

Conclusion: Addition of the CAM tool into the EHR-enhanced screening compliance.

Implications for nursing: Early delirium detection may reduce patient falls. The CAM is a feasible instrument and delirium screening is a worthwhile intervention.

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