What is the Delirium Bibliography? The searchable Delirium Bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons. It is primarily intended for clinicians and researchers interested in exploring these topics. The NIDUS team keeps it updated for you on a monthly basis!
How to Search for Articles: Search by author, title, year, and/or keywords. Each article is indexed by keywords taken from MEDLINE and other relevant databases. Click on the title of the article to read the abstract, journal, etc.
Reference Information
- Title
- A quality improvement approach to cognitive assessment on hospice admission: could we use the 4AT or Short CAM?
- Authors
- Baird, L. Spiller, J. A.
- Year
- 2017
- Journal
- BMJ Open Qual
- Abstract
Background Prevalence studies show that 13%-42% of patients admitted to specialist palliative care inpatient units have delirium. Symptoms of delirium are often subtle and easily missed, or misdiagnosed as fatigue or depression, and so the use of a screening tool could improve early identification and management of delirium and lead to improved outcomes. Patients admitted to hospices are often frail and tired, therefore a quick and easy-to-use method of cognitive assessment is essential. Methods A quality improvement (QI) approach (PDSA: Plan, Do, Study, Act) was used to improve screening for delirium on admission to a hospice unit. A baseline measure was taken of the rate of performance of cognitive assessment on admission. Five PDSA cycles were then undertaken which involved implementing change and then evaluating results through auditing case notes and interviewing staff. Results The first cycle determined staff preference between two cognitive assessment methods: the Short Confusion Assessment Method and the four ‘A’s Test (4AT). Two further PDSA cycles embedded the 4AT (the preferred tool) into the admission process, establishing it as a usable tool in the hospice setting for up to 92% of admissions. A subsequent cycle showing poor sustainability prompted staff education and changes to admission documentation, resulting in an increase in cognitive assessment being performed, from 50% to 76%. Conclusion The 4AT is a usable tool in the hospice inpatient setting to assess patients’ cognitive state on admission and can easily be incorporated into the admission process. The QI approach highlighted the need to link staff awareness of their use of the screening tool with perceived improvements in the treatment of delirium, which prompted the creation and implementation of a ‘Delirium Checklist’. Some initial lack of sustainability was addressed by staff education and changes to the admission paperwork to ensure compliance with the use of the 4AT and sustained improvement in screening for cognitive impairment.
- PMID
- Keywords
Pdsa
continuous quality improvement
healthcare quality improvement
quality improvement
- Page(s)
- Volume
- 6
- Issue
- 2
| Title | Authors | Journal | Year | Keywords |
|---|---|---|---|---|
| Factors Associated with Length of Stay in Hospital Patients with and Without Dementia. | Möllers, T. Perna, L. Ihle, P. Schubert, I. Bauer, J. Brenner, H. | Journal of Alzheimer's Disease | 2019 |
adult |
| Does a Year Have 6 Months or 12? Implications for Delirium Detection Among Hospitalized Older General Medicine Patients. | Zhou, W. Ngo, L. H. Inouye, S. K. Gallagher, J. Husser, E. K. Fick, D. M. Marcantonio, E. R. | Journal of General Internal Medicine | 2018 |
adult |
| Serum soluble fibrinogen-like protein 2 concentration predicts delirium after acute pancreatitis. | Xu, W. B. Hu, Q. H. Wu, C. N. Fan, Z. K. Song, Z. F. | Brain Behav | 2019 |
acute pancreatitis |
| Use of the brief Confusion Assessment Method in a veteran palliative care population: A pilot validation study. | Wilson, J. E. Boehm, L. Samuels, L. R. Unger, D. Leonard, M. Roumie, C. Ely, E. W. Dittus, R. S. Misra, S. Han, J. H. | Palliat Support Care | 2019 |
cognition |
| Relative cerebral hyperperfusion during cardiopulmonary bypass is associated with risk for postoperative delirium: a cross-sectional cohort study. | Thudium, M. Ellerkmann, R. K. Heinze, I. Hilbert, T. | BMC Anesthesiology | 2019 |
Cardiac surgery |
| Prediction of postoperative delirium by comprehensive geriatric assessment among elderly patients with hip fracture. | Tao, L. Xiaodong, X. Qiang, M. Jiao, L. Xu, Z. | Ir J Med Sci | 2019 |
Comprehensive geriatric assessment |
| The Overlap Between Falls and Delirium in Hospitalized Older Adults: A Systematic Review. | Sillner, A. Y. Holle, C. L. Rudolph, J. L. | Clin Geriatr Med | 2019 |
Delirium |
| Depth of sedation as an interventional target to reduce postoperative delirium: mortality and functional outcomes of the Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients randomised clinical trial. | Sieber, F. Neufeld, K. J. Gottschalk, A. Bigelow, G. E. Oh, E. S. Rosenberg, P. B. Mears, S. C. Stewart, K. J. Ouanes, J. P. P. Jaberi, M. Hasenboehler, E. A. Wang, N. Y. | British Journal of Anaesthesia | 2019 |
NCT00590707 |
| Delirium Incidence and Functional Outcomes After Transcatheter and Surgical Aortic Valve Replacement. | Shi, S. M. Sung, M. Afilalo, J. Lipsitz, L. A. Kim, C. A. Popma, J. J. Khabbaz, K. R. Laham, R. J. Guibone, K. Lee, J. Marcantonio, E. R. Kim, D. H. | J Am Geriatr Soc | 2019 |
aortic valve replacement |
| Effect of perioperative administration of dexmedetomidine on delirium after cardiac surgery in elderly patients: a double-blinded, multi-center, randomized study. | Shi, C. Jin, J. Qiao, L. Li, T. Ma, J. Ma, Z. | Clin Interv Aging | 2019 |
anesthesia |
| Perspectives on the Delirium Experience and Its Burden: Common Themes Among Older Patients, Their Family Caregivers, and Nurses. | Schmitt, E. M. Gallagher, J. Albuquerque, A. Tabloski, P. Lee, H. J. Gleason, L. Weiner, L. S. Marcantonio, E. R. Jones, R. N. Inouye, S. K. Schulman-Green, D. | Gerontologist | 2019 |
*Burden |
| Association of Persistent Intense Thirst With Delirium Among Critically Ill Patients: A Cross-sectional Study. | Sato, K. Okajima, M. Taniguchi, T. | J Pain Symptom Manage | 2019 |
Thirst |
| Role of Epileptic Activity in Older Adults With Delirium, a Prospective Continuous EEG Study. | Sambin, S. Gaspard, N. Legros, B. Depondt, C. De Breucker, S. Naeije, G. | Front Neurol | 2019 |
Ncse |
| Surgical delay is a risk factor of delirium in hip fracture patients with mild–moderate cognitive impairment. | Pioli, G. Bendini, C. Giusti, A. Pignedoli, P. Cappa, M. Iotti, E. Ferri, M. A. Bergonzini, E. Sabetta, E. | Aging Clinical and Experimental Research | 2019 |
age |
| Cerebrospinal Fluid Spermidine, Glutamine and Putrescine Predict Postoperative Delirium Following Elective Orthopaedic Surgery. | Pan, X. Cunningham, E. L. Passmore, A. P. McGuinness, B. McAuley, D. F. Beverland, D. O'Brien, S. Mawhinney, T. Schott, J. M. Zetterberg, H. Green, B. D. | Sci Rep | 2019 | |
| The impact of the Hospital Elder Life Program on the treatment of asymptomatic bacteriuria: An unexpected benefit. | O'Donnell, A. J. Walsh, T. L. Tang, A. Weinberg, L. | Geriatr Nurs | 2019 |
Asymptomatic bacteriuria |
| Continuous EEG Monitoring in a Consecutive Patient Cohort with Sepsis and Delirium. | Nielsen, R. M. Urdanibia-Centelles, O. Vedel-Larsen, E. Thomsen, K. J. Moller, K. Olsen, K. S. Lauritsen, A. O. Eddelien, H. S. Lauritzen, M. Benedek, K. | Neurocrit Care | 2019 |
Brain diseases |
| Delirium risk factors and associated outcomes in a neurosurgical cohort: a case-control study. | Morshed, R. A. Young, J. S. Safaee, M. Sankaran, S. Berger, M. S. McDermott, M. W. Hervey-Jumper, S. L. | World Neurosurg | 2019 |
Delirium |
| Biomarker Predictors of Delirium in Acutely Ill Patients: A Systematic Review. | Michels, M. Michelon, C. Damasio, D. Vitali, A. M. Ritter, C. Dal-Pizzol, F. | J Geriatr Psychiatry Neurol | 2019 |
Cam |
| Predicting postoperative delirium severity in older adults: The role of surgical risk and executive function. | Lindroth, H. Bratzke, L. Twadell, S. Rowley, P. Kildow, J. Danner, M. Turner, L. Hernandez, B. Brown, R. Sanders, R. D. | Int J Geriatr Psychiatry | 2019 |
aging |
| Subsyndromal delirium is associated with poor functional outcome after ischaemic stroke. | Klimiec-Moskal, E. Lis, A. Pera, J. Slowik, A. Dziedzic, T. | European Journal of Neurology | 2019 |
aged |
| SF-36 scores predict postoperative delirium after surgery for cervical spondylotic myelopathy. | Kin, K. Yasuhara, T. Tomita, Y. Umakoshi, M. Morimoto, J. Date, I. | J Neurosurg Spine | 2019 |
CCI = Charlson Comorbidity Index |
| Effects of massage on outcomes of adult intensive care unit patients: a systematic review. | Jagan, S. Park, T. Papathanassoglou, E. | Nurs Crit Care | 2019 |
Complementary and alternative therapies |
| Perioperative Dexmedetomidine Reduces Delirium in Elderly Patients after Lung Cancer Surgery. | Huyan, T. Hu, X. Peng, H. Zhu, Z. Li, Q. Zhang, W. | Psychiatr Danub | 2019 | |
| The Oslo Study of Clonidine in Elderly Patients with Delirium; LUCID: a randomised placebo-controlled trial. | Hov, K. R. Neerland, B. E. Undseth, O. Bruun Bratholm Wyller, V. MacLullich, A. M. J. Qvigstad, E. Skovlund, E. Wyller, T. B. | Int J Geriatr Psychiatry | 2019 |
Delirium treatment |
| Delirium and Alzheimer disease: A proposed model for shared pathophysiology. | Fong, T. G. Vasunilashorn, S. M. Libermann, T. Marcantonio, E. R. Inouye, S. K. | Int J Geriatr Psychiatry | 2019 |
Alzheimer disease |
| Development and validation of a dynamic delirium prediction rule in patients admitted to the Intensive Care Units (DYNAMIC-ICU): A prospective cohort study. | Fan, H. Ji, M. Huang, J. Yue, P. Yang, X. Wang, C. Ying, W. | International journal of nursing studies | 2019 |
aged |
| Delirium and cognitive impairment among older patients in Norwegian emergency departments. | Evensen, S. Saltvedt, I. Ranhoff, A. H. Myrstad, M. Myrstad, C. Mellingsaeter, M. Wang-Hansen, M. S. Neerland, B. E. | Tidsskr Nor Laegeforen | 2019 | |
| Motor activity across delirium motor subtypes in geriatric patients assessed using body-worn sensors: a Norwegian cross-sectional study. | Evensen, S. Bourke, A. K. Lydersen, S. Sletvold, O. Saltvedt, I. Wyller, T. B. Taraldsen, K. | BMJ Open | 2019 |
accelerometer |
| Factors Associated With Delirium in Surgical Intensive Care Unit Patients Treated With Supplemental Melatonin: A Case-Cohort Study. | Cusimano, J. M. Welch, S. Perez-Protto, S. Lam, S. | Clin Neuropharmacol | 2019 | |
| Intraoperative blood transfusion predicts postoperative delirium among older patients undergoing elective orthopedic surgery: A prospective cohort study. | Chou, M. Y. Wang, Y. C. Peng, L. N. Liang, C. K. Chu, C. S. Liao, M. C. Lin, Y. T. Hsu, C. J. Chen, L. K. | Int J Geriatr Psychiatry | 2019 |
aged |
| Postoperative delirium in critically ill surgical patients: incidence, risk factors, and predictive scores. | Chaiwat, O. Chanidnuan, M. Pancharoen, W. Vijitmala, K. Danpornprasert, P. Toadithep, P. Thanakiattiwibun, C. | BMC Anesthesiology | 2019 |
Intensive care unit (ICU) |
| Differential Clinical Characteristics, Management, and Outcome of Delirium among Ward Compared with ICU Patients. | Canet, E. Amjad, S. Robbins, R. Lewis, J. Matalanis, M. Jones, D. Bellomo, R. | Intern Med J | 2019 |
Agitation |
| Vitamin D levels and risk of delirium: A mendelian randomization study in the UK Biobank. | Bowman, K. Jones, L. Pilling, L. C. Delgado, J. Kuchel, G. A. Ferrucci, L. Fortinsky, R. H. Melzer, D. | Neurology | 2019 | |
| Single-bed rooms in a geriatric ward prevent delirium in older patients. | Blandfort, S. Gregersen, M. Rahbek, K. Juul, S. Damsgaard, E. M. | Aging Clin Exp Res | 2019 |
Delirium |
| Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016. | Aloisi, G. Marengoni, A. Morandi, A. Zucchelli, A. Cherubini, A. Mossello, E. Bo, M. Di Santo, S. G. Mazzone, A. Trabucchi, M. Cappa, S. Fimognari, F. L. Incalzi, R. A. Gareri, P. Perticone, F. Campanini, M. Montorsi, M. Latronico, N. Zambon, A. Bellelli, | J Clin Psychiatry | 2019 | |
| Patient Safety Incidents Describing Patient Falls in Critical Care in North West England Between 2009 and 2017. | Thomas, A. N. Balmforth, J. E. | J Patient Saf | 2019 | |
| Have you SCAND MMe Please? A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit. | Redley, B. Baker, T. | Journal of Clinical Nursing | 2019 |
acute disease |
| Low-Dose Ketamine Infusion to Decrease Postoperative Delirium for Spinal Fusion Patients. | Plyler, S. S. Muckler, V. C. Titch, J. F. Gupta, D. K. Rice, A. N. | J Perianesth Nurs | 2019 |
3d-cam |
| Nurses' experiences of caring for older patients afflicted by delirium in a neurological department. | Kristiansen, S. Konradsen, H. Beck, M. | Journal of Clinical Nursing | 2019 |
adult |
| Association of Delirium Response and Safety of Pharmacological Interventions for the Management and Prevention of Delirium: A Network Meta-analysis. | Wu, Y. C. Tseng, P. T. Tu, Y. K. Hsu, C. Y. Liang, C. S. Yeh, T. C. Chen, T. Y. Chu, C. S. Matsuoka, Y. J. Stubbs, B. Carvalho, A. F. Wada, S. Lin, P. Y. Chen, Y. W. Su, K. P. | JAMA Psychiatry | 2019 | |
| Effect of electroencephalography-guided anesthetic administration on postoperative delirium among older adults undergoing major surgery the engages randomized clinical trial. | Wildes, T. S. Mickle, A. M. Abdallah, A. B. Maybrier, H. R. Oberhaus, J. Budelier, T. P. Kronzer, A. McKinnon, S. L. Park, D. Torres, B. A. Graetz, T. J. Emmert, D. A. Palanca, B. J. Goswami, S. Jordan, K. Lin, N. Fritz, B. A. Stevens, T. W. Jacobsohn, E. | JAMA | 2019 |
NCT02241655 |
| Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial. | Vlisides, P. E. Thompson, A. Kunkler, B. S. Maybrier, H. R. Avidan, M. S. Mashour, G. A. | Anesth Analg | 2019 | |
| Effect of Intravenous Acetaminophen vs Placebo Combined with Propofol or Dexmedetomidine on Postoperative Delirium among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial. | Subramaniam, B. Shankar, P. Shaefi, S. Mueller, A. O'Gara, B. Banner-Goodspeed, V. Gallagher, J. Gasangwa, D. Patxot, M. Packiasabapathy, S. Mathur, P. Eikermann, M. Talmor, D. Marcantonio, E. R. | JAMA | 2019 |
NCT02546765 |
| The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery - a retrospective observational study. | Smulter, N. Claesson Lingehall, H. Gustafson, Y. Olofsson, B. Engstrom, K. G. | J Clin Nurs | 2019 |
Assessments scales |
| Incidence and predictors of postoperative delirium in the older acute care surgery population: a prospective study. | Saravana-Bawan, B. Warkentin, L. M. Rucker, D. Carr, F. Churchill, T. A. Khadaroo, R. G. | Canadian Journal of Surgery | 2019 |
aged |
| Association of Duration of Surgery With Postoperative Delirium Among Patients Receiving Hip Fracture Repair. | Ravi, B. Pincus, D. Choi, S. Jenkinson, R. Wasserstein, D. N. Redelmeier, D. A. | JAMA Netw Open | 2019 | |
| Depression Predicts Delirium After Coronary Artery Bypass Graft Surgery Independent of Cognitive Impairment and Cerebrovascular Disease: An Analysis of the Neuropsychiatric Outcomes After Heart Surgery Study. | Oldham, M. A. Hawkins, K. A. Lin, I. H. Deng, Y. Hao, Q. Scoutt, L. M. Yuh, D. D. Lee, H. B. | American Journal of Geriatric Psychiatry | 2019 |
aged |
| Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer. | Neefjes, E. C. W. van der Vorst, Mjdl Boddaert, M. S. A. Verdegaal, Batt Beeker, A. Teunissen, S. C. C. Beekman, A. T. F. Zuurmond, W. W. A. Berkhof, J. Verheul, H. M. W. | BMC Cancer | 2019 |
Delirium |
| The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study. | Nagae, M. Egi, M. Furushima, N. Okada, M. Makino, S. Mizobuchi, S. | J Anesth | 2019 |
Delirium |
| Association between delirium, adverse clinical events and functional outcomes in older patients admitted to rehabilitation settings after a hip fracture: A multicenter retrospective cohort study. | Morandi, A. Mazzone, A. Bernardini, B. Suardi, T. Prina, R. Pozzi, C. Gentile, S. Trabucchi, M. Bellelli, G. | Geriatrics & Gerontology International | 2019 |
aged |
| Handover of anesthesia care is associated with an increased risk of delirium in elderly after major noncardiac surgery: results of a secondary analysis. | Liu, G. Y. Su, X. Meng, Z. T. Cui, F. Li, H. L. Zhu, S. N. Wang, D. X. | J Anesth | 2019 |
Delirium |
| Undiagnosed delirium is frequent and difficult to predict: Results from a prevalence survey of a tertiary hospital. | Lange, P. W. Lamanna, M. Watson, R. Maier, A. B. | J Clin Nurs | 2019 |
Undiagnosed delirium |