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A Quality Improvement Study on Delirium Awareness Day: In Pursuit of Missed Delirium Diagnoses
Journal of Gerontological Nursing ( IF 1.1 ) Pub Date : 2022-08-01 , DOI: 10.3928/00989134-20220630-03
Meltem Koca , Yelda Öztürk , İlker Boğa , Suna Bürkük , Mert Eşme , Yasemin Akyürek , Sevgi Şimşek , Derya Durmaz Aydın , Filiz Çiçek , Erdem Karabulut , Meltem Halil , Mustafa Cankurtaran , Mine Durusu Tanrıöver , Burcu Balam Doğu

The current study aimed to screen for delirium in hospitalized older adults and assess the validity of the Turkish version of the 4A's Test (4AT-TR) as a feasible tool to integrate in routine patient care. The point prevalence of delirium according to clinical evaluation in routine practice was detected among all patients aged ≥60 years in 12 pilot wards. Delirium screening was then conducted by two arms: (a) nurses using the 4AT-TR and (b) geriatricians according to Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. Prevalence of delirium according to clinical impression was 3.3% (n = 4), whereas prevalence was 12.4% (n = 17) according to DSM-5 criteria and 13.8% (n = 17) according to the 4AT-TR. The 4AT-TR performed by nurses had a sensitivity of 66.6% and specificity of 93.5%. Area under the receiver operating characteristic curve for delirium diagnosis was 0.819 (p < 0.001). Most delirium cases remain undetected unless a routine and formal delirium assessment is integrated in hospital care of high-risk patients. The 4AT-TR performed by nurses seems to be a valid tool for determining delirium in hospitalized older adults. [Journal of Gerontological Nursing, 48(8), 43–51.]



中文翻译:

谵妄宣传日的质量改进研究:追求错失的谵妄诊断

目前的研究旨在筛查住院老年人的谵妄,并评估土耳其版 4A 测试 (4AT-TR) 作为融入常规患者护理的可行工具的有效性。在 12 个试点病房的所有年龄 ≥ 60 岁的患者中,根据常规实践中的临床评估检测了谵妄的点患病率。然后由两个部门进行谵妄筛查:(a) 使用 4AT-TR 的护士和 (b) 根据精神疾病诊断和统计手册第 5 版( DSM-5 ) 标准的老年科医生。根据临床印象,谵妄的患病率为 3.3%(n = 4),而根据DSM-5标准的患病率为 12.4%(n = 17)和 13.8%(n = 17) 根据 4AT-TR。护士进行的 4AT-TR 的敏感性为 66.6%,特异性为 93.5%。谵妄诊断的受试者工作特征曲线下面积为 0.819 ( p < 0.001)。除非将常规和正式的谵妄评估整合到高危患者的医院护理中,否则大多数谵妄病例仍未被发现。护士执行的 4AT-TR 似乎是确定住院老年人谵妄的有效工具。[老年护理杂志,48(8),43-51。]

更新日期:2022-08-02
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