Effects Of Cycled Lighting On Delirium Essay

According to Mc Donnell & Timmons (2012), “Acute delirium is a preventable, treatment, disorder of consciousness and cognition that commonly presents across many healthcare settings, including older care facilitates, medical and surgical ward, intensive care units and children’s ward”(p.2488). In their article, A quantitative exploration of the subjective burden experienced by nurses when caring for patients with delirium, Mc Donnell and Timmins outline a descriptive study. Even though prevention and treatments are well recognized, dealing with delirium can be very difficult. The purpose of this study is to examine the subjective burden nurses experience when caring for patients with delirium and to identify the individual aspects of delirium that nurses find most difficult to deal with. In the introduction of the article, the authors argue that beyond qualitative studies there is insufficient practical research on the impact and burden of delirium on nurses in practice (Mc Donnell & Timmins, 2012). This argument outlines the premise behind the research. It is not a research question, but a statement of belief upon which they draw in framing the purpose and focus of their research. The authors articulate their recognition of the fact that many researchers have only focused on the diagnosis, treatment, and prevention for delirium. In addition, they also recognized that nurses often lack knowledge and understanding

“Delirium results for an interaction between predisposing factors, which increases the person’s vulnerability, and precipitating factors, which account for the immediate threat.” (Miller, 2015) The environment the patient is in can also play a role in the patient’s acute confusion. The environment is unfamiliar. The patient’s decreased urine output can also play a role in the acute confusion. The toxins are building up in the patient’s system and this can lead to acute confusion.

Delirium tremens is a serious condition and can be life threatening. Most people need treatment in a hospital or a detox unit.

ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).

The medical cases of delirium have been rising of late among patients. However, in comparison to other medical sections, there exist a higher prevalence rates in intensive care unit. According to the medical statistics in the United States, the prevalence rates of delirium range between 11% to 42% with the highest rate in the Intensive Care Unit (ICU) standing at 87% (Rivosecchi, Smithburger, Svec, Campbell, & Kane-Gill, 2015). In terms of the population affected, delirium affects 20% to 50% of non-mechanical patients and 60% to 80% of patients admitted to the ICU (Gregory, 2016). Furthermore, the financial impact of ICU delirium per year in the United States so far has been $4 to16 billion dollars (Arumugam, El-Menyar, Al-Hassani, Strandvik,

Other types of medications that have been found effective in treating ICU delirium are benzodiazepines, propofol and dexmedetomidine (13). Dexmedetomidine (0.2-1.5 µg/kg/h, intravenously) is a centrally acting alpha- 2a agonist with rapid sedative effects and anxiolytic/analgesic properties. This medication has gained popularity among ICU physicians, because it has minimal impact on respiratory drive, proposes predictability and has an aminobutyric acid–sparing mechanism of action(100,

Hospitalized patients are often hooked up to monitoring devices such as heart monitors, which monitor the electric activity of the heart, or connected to a physiological monitor so their vital signs are constantly being measured. These monitors are intended to continuously assess the patients’ status, and alarm if the patients’ status drops below what is considered normal. The increased use of monitoring devices has created a new phenomenon known as alarm fatigue. According to the ECRI institute (2011), “alarm fatigue occurs when the sheer number of alarms overwhelms staff and they become desensitized to the alarms resulting in delayed alarm response and missed alarms-often resulting in patient harm or even death.” Alarm fatigue has

critically ill intubated patients and is an important cause of mortality and morbidity in ICU

Delirium is defined as “a disturbance of consciousness and cognition that develops over a short period of time and fluctuates over time” (Boogaard, et al., 2010, p. 2). While delirium is transient and often reversible, research has shown that it is also a valid predictor of mortality in critically ill patients. Timothy D. Girard states in his article, Delirium in the intensive care unit, that “patients with delirium have longer hospital stays and lower 6-month survival than do patients without delirium, and preliminary research suggests that delirium may be associated with cognitive impairment

In order to measure a patient’s education level regarding the procedure, outcomes and after surgical care all study participants were give a “10- item Knowledge Test” that was developed by the researchers and reviewed by an independent panel of seven experts in the field of critical care (Chevillon et al., 2015). The reliability of the “10- item Knowledge Test” was not discussed by the authors; therefore, the reliability of this test is low and should be question. Further, Chevillon and researchers assess delirium by implementing ed a two part assessment of delirium by first using the “Confusion Assessment Method for Intensive Care Units” which is comprised four components that measure: (1) onset, fluctuation or changes in mental status, (2) lack of attention, (3) unorganized mental processing, and (4) changes in consciousness which was measured by using the “Richmond Agitation and Sedation Scale (Chevillon et al., 2015). As with the “10- item Knowledge Test”, the “Confusion Assessment Method for Intensive Care Units” reliability was not discussed by the authors of the study and the reliability cannot be established; however, in one study found the “Confusion Assessment Method for Intensive Care Units is an excellent diagnostic tool in critically ill ICU patients”, (Gusmao-Flores, Salluh, J. I. F., Chalhub, and

Definition: serious mental disturbance that causes patient to lose grip of reality and become confused and comes on suddenly

Intensive care units (ICUs) are complex work environments where clinical alarms are vital to warn the staff when patient’s condition changes. Clinical alarms in the ICU are designed to aware the clinical staff of any conditions that require immediate attention or action in order to ensure quality of care and patient safety. However, false alarms in the ICU may cause some problems in providing care to critical patients. According to The Joint Commission National Patient Safety Goal, “06.01.01 targeted improving the safety of clinical alarm systems and required health care facilities to establish alarm systems safety as a hospital priority by July 2014. An important initial step toward this requirement is identifying ICU nurses’ perceptions and

Hello Erica, I enjoyed reading your post this week. As you mentioned not knowing what to expect when you go to work is something many nurses deal with on a daily basis. Working in critical care, I often encounter the same unknowns, each day is different than the last. Noise within a department, be it a mental health unit or an intensive care unit (ICU), can affect a patient similarly. ICU delirium often occurs where I work because of the constant level of noise and interruptions in one’s routine. Delirium a change in a patient’s consciousness leads to agitation, restlessness and it affects up to 80% of patients in the intensive care unit (ICU). It is estimated that ICU costs associated with delirium costs anywhere between $4 billion and $16

Another study, “inhalant abuse: a clinic-based study published reports inhalant abuse/dependence”, showed different types of cases, 2/3 of the subjects reported that intoxication as a feeling of relaxation and they had symptoms of giddiness, unsteadiness or perceptual disturbances, and consciousness or delirium and lightheadedness. Then a comprehensive study on delirium includes the rates of delirium, but the most important was the screening tool that is the CAM for delirium. This study is called, Post Traumatic Hyperactive Delirium, in this study it points out the main common problem that follows a head injury. In this study they concluded that the occurrence of delirium was related to the cerebral disturbances that was due to the diffusion of the damage in accelerated injuries and metabolic or post seizure disturbances in contact injuries. When Looking at the patients regularly they discovered that psychiatric problems was becoming more common among them. Another study mentioned was the, “ECT and Clozapine Combination Producing delirium: A Case Report”, this study mentions that using ECT and clozapine at the same time describes a case about going into delirium follows the combination and that delirium is resolving based on not continuing the use of

Best practice of early mobility for the critically ill patients is not clearly defined due to the lack of scientific research and absence of national standard guidelines. Guidelines based on individual research studies suggest the implementation of early mobility program as soon as the patient is admitted or clinically stable (Chandrashekar & Perme, 2009). Different approaches are presented to accomplish the early mobilization program including Awakening and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility (ABCDE) bundle and the four phase program (Balas, Boehm, Burke, Ely, Olsen, Pun, Peitz, & Vasilevskis, 2012;