The topic of delirium is nothing new to the nursing world… in fact I have had my fair share of pts suffering from delirium or new onset confusion.  Unlike dementia, delirium is typically an acute chane that may be reversed when the underlying problem is corrected. ICU delirium is actually a new topic for me.  Still keeping with the traditional definition, this acute change in mental status seems to affect pts that are sedated in the ICU while on a ventilator.  There is more recent research available on this topic, as it is still being explored and discovered.  It appears that after sedation is stopped and the pt is able to live in reality, the delirium may be reversed, but some emotional trauma
remains.  I found a recent peer reviewed article that details the main streamed assessment tool for ICU delirium.  This tool is called CAM-ICU, or Confusion Assessment Method for the Intensive Care Unit.  This article outlines an educational plan among people who are administering the test and utilizing the tool to ensure they are recording data accurately.  It was found that after the educational plan was implemented, less “unable to assess” ratings were recored and pts were able to receive a more appropriate grade.  As with most things in the medical world, the more knowledge medical professionals have the more meaningful outcomes pts may have.  Proper education for this assessment tool is instrumental in screening pts for delirium and reversing this confusion before mental health complications occur.  A copy of the CAM-ICU Assessment Worksheet is provided for review.

Reference

SWAN, J. DECREASING INAPPROPRIATE UNABLE-TO-ASSESS RATINGS FOR THE CONFUSION ASSESSMENT METHOD FOR THE INTENSIVE CARE UNIT. American Journal of Critical Care. 23, 1, 60-69, 2014. ISSN: 1062-3264.

The “Digital Trends in Nursing” blog is a comprehensive opinion based blog designed to bring fourth changing technologies and how it is being incorporated into the nursing world.  Unfortunately the blogger (Raney Linck) has not kept up the site, and the most recent post is almost a full year old. With the continued advances in technology, and integration of that technology in healthcare, it is important to remember that changes happen everyday.

I feel like the technology referenced in this blog is becoming more mainstreamed and is available to the masses, not just health care providers.  I feel in the next few months the department I work for will be utilizing the technology available; in fact, today I participated in an inservice for my hospitals new tele robot.  This robot will be replacing the current tele stroke robot, that essentially video conferences a neurologist to a potential stroke patient, and will be used to conduct follow up appointments in the emergency room and connect patients with specialists that would otherwise have to travel to the facility.  This robot, and technology like it, enhances the assessment process, it does not replace it.  It remains the nurses responsibility to be the eyes and ears in the physical room and participate the in advanced assessment process.

It is also important to remember that these technologies are made to enhance the assessment process and do not necessarily replace the need for more “basic” or “primitive” testing; example being an EKG monitors the electrical activity of the heart, but does not replace the importance of auscultating for heart and valve sounds.

It is also important for follow up and proper education if people are bringing these technologies into their homes for self care.  Home health agencies or monitoring companies must be notified to follow up to ensure the patient is truly being cared for and does not have a false sense of safety.  Continual monitoring and health applications could give a better overall picture to the patients daily health status but must be interoperated by a medical doctor and not the redly available “doctor google”.

There is a never ending story of research conducted by multiple agencies, hospitals, and educational centers.  It is important for the health care provider to be alerted to the ever powerful “evidence based practice” research.  Only when research is conducted, tested, and proven in a clinical setting does it become the standard for health care.  As technology advances new tools will be available for clinicians and for people to use at home.  Some pros of mobile technology include the potential for fewer hospital stays, monitoring patients, better recovery outcomes, and an overall better quality of life.  Some cons of mobile technology include false sense of security, interrupted or malfunction of equipment, and poor knowledge of equipment available.

In the hospital I work at, we encourage patients to utilize the technologies available; from blood sugar checks, blood pressure machines, heart rate and oxygen saturation finger probes, and an ACCURATE thermometer.  These are now basic technologies that are common in many homes that, when utilized appropriately, can alert a patient or practitioner of acute health changes that need additional treatments.

Hello!

My name is Victoria Watkins. I have been married to my best friend for just over 8 years, and he is my everything.  I graduated from Moorpark Community College in December of 2013 and started my nursing journey in the Emergency Room at Providence Little Company of Mary in June 2014.  I am currently continuing my education at CSUCI and my husband is continuing his education at CSUDH; eventually I want to get a masters in nursing and probably go into education, whereas my husband is working towards his doctorate in business.  Right now I am focusing on my bachelors degree and career certifications; by the end of 2016 I plan on having my MICN (mobil intensive care nurse), TNCC (trauma nursing core course), and CEN (certified emergency nurse) certification.  When the books are closed and the computers are shut off, my husband and I enjoy spending time with family and friends.  We enjoy hiking, going to disneyland, and exploring all that Southern California has to offer.