Evidence map›Paper›PMID 32236428›Full record

ArticleCritical care nurse2020

Early Identification of Delirium in Intensive Care Unit Patients: Improving the Quality of Care.

Jessica Spiegelberg, Huaxin Song, Brenda Pun, Paula Webb, Leanne M Boehm

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care nurse, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Best Practices in Oral Care.Critical care nurse · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jessica SpiegelbergJessica Spiegelberg is an advanced practice nurse and liaison for psychiatric consultations, Covenant Medical Center and University Medical Center, Texas Tech University Health Sciences Center, Lubbock, Texas. Huaxin Song is program manager and principal investigator, Texas Tech University Health Sciences Center. Brenda Pun is an advanced practice nurse in the Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee. Paula Webb is an associate professor and faculty advisor for Doctor of Nursing Practice students, School of Nursing, Texas Tech University Health Sciences Center. Leanne M. Boehm is an assistant professor at the Vanderbilt University School of Nursing and the Center for Critical Illness, Brain Dysfunction, and Survivorship, Vanderbilt University Medical Center.
Huaxin SongJessica Spiegelberg is an advanced practice nurse and liaison for psychiatric consultations, Covenant Medical Center and University Medical Center, Texas Tech University Health Sciences Center, Lubbock, Texas. Huaxin Song is program manager and principal investigator, Texas Tech University Health Sciences Center. Brenda Pun is an advanced practice nurse in the Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee. Paula Webb is an associate professor and faculty advisor for Doctor of Nursing Practice students, School of Nursing, Texas Tech University Health Sciences Center. Leanne M. Boehm is an assistant professor at the Vanderbilt University School of Nursing and the Center for Critical Illness, Brain Dysfunction, and Survivorship, Vanderbilt University Medical Center.
Brenda PunJessica Spiegelberg is an advanced practice nurse and liaison for psychiatric consultations, Covenant Medical Center and University Medical Center, Texas Tech University Health Sciences Center, Lubbock, Texas. Huaxin Song is program manager and principal investigator, Texas Tech University Health Sciences Center. Brenda Pun is an advanced practice nurse in the Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee. Paula Webb is an associate professor and faculty advisor for Doctor of Nursing Practice students, School of Nursing, Texas Tech University Health Sciences Center. Leanne M. Boehm is an assistant professor at the Vanderbilt University School of Nursing and the Center for Critical Illness, Brain Dysfunction, and Survivorship, Vanderbilt University Medical Center.
Paula WebbJessica Spiegelberg is an advanced practice nurse and liaison for psychiatric consultations, Covenant Medical Center and University Medical Center, Texas Tech University Health Sciences Center, Lubbock, Texas. Huaxin Song is program manager and principal investigator, Texas Tech University Health Sciences Center. Brenda Pun is an advanced practice nurse in the Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee. Paula Webb is an associate professor and faculty advisor for Doctor of Nursing Practice students, School of Nursing, Texas Tech University Health Sciences Center. Leanne M. Boehm is an assistant professor at the Vanderbilt University School of Nursing and the Center for Critical Illness, Brain Dysfunction, and Survivorship, Vanderbilt University Medical Center.
Leanne M BoehmJessica Spiegelberg is an advanced practice nurse and liaison for psychiatric consultations, Covenant Medical Center and University Medical Center, Texas Tech University Health Sciences Center, Lubbock, Texas. Huaxin Song is program manager and principal investigator, Texas Tech University Health Sciences Center. Brenda Pun is an advanced practice nurse in the Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee. Paula Webb is an associate professor and faculty advisor for Doctor of Nursing Practice students, School of Nursing, Texas Tech University Health Sciences Center. Leanne M. Boehm is an assistant professor at the Vanderbilt University School of Nursing and the Center for Critical Illness, Brain Dysfunction, and Survivorship, Vanderbilt University Medical Center.

Funding

Vanderbilt Scholars in T4 Translational Research (V-STTaR) ProgramK12HL137943 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI KRIPALANI, SUNIL, ROUMIE, CHRISTIANNE L. · 2017 to 2021
$2.9M
NHLBI NIH HHS K12 HL137943
6 · The paper itself

Abstract

backgroundDelirium has long-term consequences for intensive care unit patients. The project site, an urban academic hospital, did not previously use a validated delirium screening tool, and patients commonly received sedative medications to treat agitation.

objectiveTo minimize the risk of delirium by implementing the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) as the standard-of-care delirium assessment tool in the intensive care unit and by decreasing use of high-risk medications (ie, opioids and benzodiazepines).

methodsAn observational pretest-posttest design was used to analyze deidentified patient data from electronic health records. The evidence-based practice intervention focused on educating nurses on high-risk medications and CAM-ICU implementation. Control charts, χ2 tests, and mixed regression models were used to evaluate the effectiveness of the intervention in reducing delirium risk by decreasing use of high-risk medications.

resultsHigh-risk medication use significantly decreased after intervention among patients at low risk for delirium (before intervention, 7.37%; after intervention, 3.92%; P < .001) and at high risk for delirium (before intervention, 4.73%; after intervention, 2.99%; P < .001). Hospital stays were significantly shorter in patients at low risk than at high risk for delirium (P < .001) but increased by a mean of 0.13 days with each additional high-risk medication used (P < .001).

conclusionsThe variation of high-risk medication use was significantly controlled with the implementation of CAM-ICU and education. Nurses felt that hands-on training with the CAM-ICU increased their comfort in identifying patients at risk for delirium. Future work will focus on assessment accuracy.

Indexed as

Early DiagnosisPractice Guidelines as TopicAdultAgedAged, 80 and overCritical Care NursingDeliriumFemaleHumansMaleMass ScreeningMiddle AgedNursing Staff, Hospital

Identifiers

PMID32236428
PMCPMC7426069

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.