A pilot volunteer reader programme decreases delirium days in critically ill, adult ICU patients

BMJ Open Quality

article

Sarah Jordan Reif¹  A Joseph Layon² 

[1] Case Western Reserve University;Department of Anesthesiology , University of Central Florida College of Medicine;Professor of Anesthesiology , UniCamillus —International Medical University

关键词: continuous quality improvement;    critical care;    patient-centred care;    patient satisfaction;    quality improvement;   

DOI  :  10.1136/bmjoq-2019-000761

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Delirium, a form of acute brain dysfunctionpresenting as altered mental status, andimpairment of memory, emotion, thinking,perception and behaviour1 develops overhours to days2 and is seen in 20%–80%1 3of adult intensive care unit (ICU) patients,depending on the diagnostic method andseverity of illness. Delirium diagnosis is oftenmissed, as only 25% of patients experiencingthis disorder are hyperactive.1 3 More prevalent is hypoactive delirium: patients appearingsedated, responding slowly to instructionsor questions and, rarer still, mixed deliriumpatients may be hyperactive and hypoactive.3 4 There is also subsyndromal delirium,representing an intermediate state—notnormal and yet not fully developed delirium.Delirium can lead to serious complicationsincluding increased length of ICU stay andincreased readmission, institutionalisationand mortality rates.3 5 If not diagnosed ortreated, delirium may lead to irreparable6and delayed7–9 cognitive failure.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND