Module 1 - Delirium

Objectives

• Understand the serious impact of delirium on the hospitalized older adult
• Identify signs and symptoms of delirium
• Identify baseline risk factors or "predisposing factors" for delirium
• Recognize common precipitating causes of delirium
• Implement nursing interventions to prevent or manage delirium

Required Material

Summary

• The unfamiliar surroundings of the hospital, the patient's risk factors or vulnerability, and physiologic factors or new insults interact to precipitate delirium
• Delirium is usually multi-factorial involving patient risks of age, and sensory, cognitive and functional deficits, and new insults such as environment, infection and medication
• Recognition of risk factors and early interventions can reduce incidence of delirium and reduce morbidity and mortality

References

1. Inouye S, Bogardus S, Charpentier P, Leo-Summers L, et al. (1999). A multicomponent intervention to prevent delirium in hospitalized older patients.  New England Journal of Medicine. 340(9): 669-676.
2. Inouye S, van Dyck C, Alessi C, et al. (1990). Clarifying confusion: the confusion assessment method.  Annals of Internal Medicine. 113(12):941-948.
3. Lee V (2005). Confusion: Geriatric Self-Learning Module. MEDSURG Nursing. 12(1), 38-41.
4. Waszynski C (2007). Detecting delirium. AJN. 107(12): 50-61.

Web Resources

• John A. Hartford Institute for Geriatric Nursing
• Consult GeriRN.org
• The Hospital Elder Life Program