Delirium, a sudden onset and fluctuating cause of mental status often occurs in critical ill patients hospitalized in the ICU. Memory and language difficulty, disorientation, paranoid ideas are part of delirium with an increase in morbidity and mortality in the elderly (Svenningsen & Tonnesen, 2011). ICU delirium can be divided in hyperactive delirium with symptoms such as restlessness, aggression, and psychomotor hyperactivity. Hypoactive delirium portrays symptoms such as lethargic, and decreased psychomotor responds. Mixed delirium consist out of hyper-and hypoactive delirium. A study was performed in three ICU’s in Denmark with the goal to identify the correlation of delirium regarding analgesics, sedatives, opiods and age. Intubated and non-intubated patients participated in the study. In this particular study a correlation was detected between delirium and the length of stay in the ICU and an increase in mortality was observed in patients who died in the ICU with delirium. 40% of the patients in the ICU developed delirium. The usage of Fentanyl as an analgesic occurred to show also an increase in delirium. In order to reduce the incidence of delirium in the elderly it is important to manage cognitive impairment, immobility, and sleep deprivation, visual and hearing impairment.
Delirium is frightening experience for the patient and needs to be addressed immediately. It is interesting to read 40% of patients in ICU develop delirium, a concerning number. The article does not elaborate too much in the prevention of delirium which is disappointing. As nurses we are the patient’s advocates and have a unique role in the prevention and detection of delirium.
(Svenningsen H Tonnesen E 2011 Delirium incidents in three Danish intensive care units)Svenningsen, H., & Tonnesen, E. (2011). Delirium incidents in three Danish intensive care units. Nursing in critical care, 16(4), 186-192.
Technology has definitely brought a change in healthcare and nursing. A cell phone case with the capacity of an EKG monitor, ear buds monitoring your heart beat and the amount of calories you burn are all incredible interventions (Linck, 2014). In 2000 the Food and Drug Administration approved the robotic surgery with the da Vinci Surgical System where more complex and delicate procedures can be performed. It also increase surgery’s to be minimal invasive with the results of a decrease in complications such as infections of the surgical site, decrease in blood loss, faster recovery, and smaller scars (Mayo clinic, 2015). In nursing electronic charting, electronic MAR, and Krames are just a few of the important electronic programs in daily nursing. In nursing school and as a new graduate flexibility in learning different charting programs throughout the different hospitals was essential. Next year at my workplace we will be trained on a new charting program named Epic.
There are pros and cons towards technology and healthcare. The internet is a quick resource for patients to find out regarding their condition in using websites such as WebMD; however self diagnosis is not the best option. Follow up care with the primary care physician or specialist needs to be established. A critical care nurse tried to catch up with the morning medications after the patient had a change in condition and required different procedures. The nurse in a hurry crushed the medication and administered the medications through the NG tube including the “Do not crush” medication warning listed on the electronic medication administration record. A crushed extended-release calcium channel blocker was administered to the patient resulting in the patient’s death (Anderson and Townsend, 2013). Technology is an asset to healthcare and nursing, however it can not replace the human brain.
Linck, R. (2014, October 8). Digital trends in nursing. Retrieved September 6, 2015, from http://digitaltrendsinnursing.blogspot.com/
Anderson, P., & Townsend, T. (2013, March). Medication error: Don’t let them happen to you. Retrieved September 6, 2015, from http://www.americannursetoday.com/medication-errors-dont-let-them- happen-to-you.
Mayo Clinic. (2015, July 2). Robotic Surgery. Retrieved September 6, 2015, from http://www.mayoclinic.org/tests-procedures/robotic- surgery/basics/definition/prc-20013988
My name is Chantal Bonner. I was born and raised in the Netherlands but moved to the Unites States in my twenties. I am a mom to three awesome little ones. All three are girls ages 7, 5, and 14 months. We are foster parents and were blessed to adopt our seven and five year old in 2013. They are biological sisters and came in our care at 10 months and three years. We are currently fostering a fourteen months old baby girl. She came in our home at three weeks! We are praying we will be able to adopt her. I work as an RN at Cottage Rehabilitation Hospital however my goal is to work in pediatrics/NICU. As I mentioned before I grew up in Holland. I finished music college and got two bachelors, one in classical piano and one in music education. I moved to the USA in 2000 and studied at Maryland Bible College and Seminary in Baltimore. I received a bachelors in biblical studies and church ministries. I worked for many years in music as a choir director, assistant producer and talent recruiter. I had the privilege to direct 19 tours, touring throughout the USA and Europe visiting Germany, Denmark, Sweden, Poland, Austria, Switzerland and every state in the USA except Vermont:) Being from Europe I had the privilege to travel around and was able to visit France including Paris, Italy, Belgium, Luxembourg, Spain, and England where I worked for a month when I was 17. I am a blessed women having had the opportunity to travel, give concerts, meet thousands of people, give hundreds of concerts. I met my husband in 2002. We worked for the same music ministry and ended up getting married on September 6th, 2008…so yes this coming Sunday we are celebrating our 7th anniversary!