Delirium has been recognized as a serious acute medical condition that’s been called a medical emergency. Every day, 30,000 to 40,000 ICU patient in the United States are suffering from acute brain dysfunction called delirium (Maniou, 2012). Delirium is a manifestation of CNS dysfunction, it is important to recognize and treat life-threatening conditions that may result in delirium such as; sepsis, pneumonia, myocardial infarction, pulmonary embolism and medications. It’s recommended that after nurses’ exclude life-threatening complications that they turn their attention to the patients environment and make attempts to minimize any factors that may exacerbate delirium such as; avoiding prolonged sleep deprivation, minimizing artificial lighting, and being mindful of clustering patient care to avoid additional disruptions.
Patients on mechanical ventilation increase the risk of delirium three-fold. It has been found that the mortality rate with patients experiencing delirium may exceed twice the six-month mortality rate of nondelirious patients, and it is associated with longer hospital stays and with a higher rate of cognitive impairment at discharge (Maniou, 2012). CAM-ICU is a useful tool in diagnosing and monitoring delirium and is recommended to be used frequently in the ICU, it is constructed with yes/no questions for use with nonspeaking, mechanically ventilated ICU patients. To reduce the length of time patients spend heavily sedated and immobilized on a ventilator healthcare providers are awakening patients from sedation earlier, assessing pain, and getting them to breathe on their own as soon as possible to avoid prolonged delirium which can have long lasting effects on cognitive function. Focus is also aimed at getting patients up and moving while still on a ventilator can also help reduce muscle weakness and assist in a speedier recovery.
Landro, L. (2011). Informed patient: changing sedation status quo in the ICU. Health Blog, Wall Street Journal. Retrieved from http://blogs.wsj.com/health/2011/02/15/changing-the-sedation-status-quo-in-the-icu/
Maniou, M. (2012). Delirium: a distressing and disturbing clinical event in a intensive care unit. Health Science Journal, Vol 6, Issue 4.
Technology is constantly growing and changing the way we do things as nurses for the purpose of improving patient care and outcomes. I think technology advances are wonderful in the healthcare setting and something all healthcare providers need to embrace for the benefits of our patients. For me as a nurse this means I need to stay educated and engaged in what’s going on and to not be afraid of accepting change in the workplace. My hospital recently began scanning patients’ wrist bands and medications to minimize medication errors and this has proven to be beneficial. As far as technology relating to assessment, once these applications become more mainstream our patient’s will address their health issues with us and most likely refer to their mobile devices to give us history on their health status and conditions. The U.S. Food and Drug Administration approved the $200 iPhone case that turns your phone into an EKG monitor to prevent incidences of stroke which shows technology aiding in managing care at home. A Canadian randomized clinical trial found that AF was diagnosed five more times in patients that wore special monitors for 30 days than for those who underwent 24 hour testing, the American Heart Association also supports the prolonged EKG monitoring. The pros to technology are advances in patient outcomes, the cons are protecting patient privacy with all of the data that’s collected. So far I’ve seen technology for patient education being provided through the television sets in each room that provide videos on a diagnosis specific to each patient. I’ve also seen technology used such as iPods providing translation services. As nurses we need to make sure that we utilize and practice the best research out there and that means embracing technology for improving patient outcomes.
Hello classmates, for those of you that don’t know me my name is Lauren Thomas. I live in Santa Barbara and currently work at Cottage Hospital on the Telemetry floor as an RN. I started at Cottage Hospital almost a year ago and went through their new grad program, which was a wonderful experience! I’m currently working nights but I’m hoping I get to switch to the day shift soon as I miss my sleep!
I finished my ADN at Mount St. Mary’s College in Los Angeles because the waitlist for the RN program in Santa Barbara was over 4 years long. I lived in a cute “hipster” part of town called Los Feliz and enjoyed hiking to Griffith Park as well as frequenting the many restaurants in the area. I chose to continue my education at CSUCI because I believed that I needed to obtain a BSN in order to stay current in the nursing profession. This as been a challenge being a new nurse on the night shift and keeping up with school, but it’s something I know I’ll appreciate later into my career.
In my free time I enjoy spending time with my family and friends. I love being outdoors, whether it’s running on the beach, hiking the many trails of Santa Barbara, or enjoying a glass of wine in Santa Ynez Valley. I love animals and have Persian kitty at home who keeps me company. When I’m done with the BSN program my goals are to travel more, I’m thinking Bali might be a good idea when I graduate!
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