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Delirium in older hospitalized patients—signs and actions: a retrospective patient record review
Skaraborg Hospital, Skövde, Sweden / Jönköping University, Jönköping, Sweden.
University of Skövde, School of Health and Education. University of Skövde, Health and Education. (Välbefinnande vid långvariga hälsoproblem (VLH), Wellbeing in long-term health problems (WeLHP))ORCID iD: 0000-0002-9771-6640
Jönköping University, Jönköping, Sweden.
Skaraborg Hospital, Skövde, Sweden.
2018 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, no 1, p. 1-11, article id 43Article, review/survey (Refereed) Published
Abstract [en]

Background

Delirium is common in older hospitalized patients, and is associated with negative consequences for the patients, next of kin, healthcare professionals and healthcare costs. It is important to understand its clinical features, as almost 40% of all cases in hospitals may be preventable. Yet, delirium in hospitalized patients is often unrecognized and untreated. Few studies describe thoroughly how delirium manifests itself in older hospitalized patients and what actions healthcare professionals take in relation to these signs. Therefore, the aim of this study was to describe signs of delirium in older hospitalized patients and action taken by healthcare professionals, as reported in patient records.

Methods

Patient records from patients aged ≥65 (n = 286) were retrospectively reviewed for signs of delirium, which was found in 78 patient records (27%). Additionally, these records were reviewed for action taken by healthcare professionals in relation to the patients’ signs of delirium. The identified text was analyzed with qualitative content analysis in two steps.

Results

Healthcare professionals responded only in part to older hospitalized patients’ needs of care in relation to their signs of delirium. The patients displayed various signs of delirium that led to a reduced ability to participate in their own care and to keep themselves free from harm. Healthcare professionals met these signs with a variation of actions and the care was adapted, deficient and beyond the usual care. A systematic and holistic perspective in the care of older hospitalized patients with signs of delirium was missing.

Conclusion

Improved knowledge about delirium in hospitals is needed in order to reduce human suffering, healthcare utilization and costs. It is important to enable older hospitalized patients with signs of delirium to participate in their own care and to protect them from harm. Delirium has to be seen as a preventable adverse event in all hospitals units. To improve the prevention and management of older hospitalized patients with signs of delirium, person-centered care and patient safety may be important issues.

Place, publisher, year, edition, pages
BioMed Central, 2018. Vol. 18, no 1, p. 1-11, article id 43
Keywords [en]
Signs of delirium, Neurocognitive disorders, Older hospitalized patients, Person-centered care, Patient safety, Patient participation, Action by healthcare professionals, Qualitative content analysis
National Category
Nursing
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
URN: urn:nbn:se:his:diva-14726DOI: 10.1186/s12877-018-0731-5ISI: 000424758800002PubMedID: 29409468Scopus ID: 2-s2.0-85041523709OAI: oai:DiVA.org:his-14726DiVA, id: diva2:1181124
Available from: 2018-02-07 Created: 2018-02-07 Last updated: 2018-03-08

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