All posts by vbarrettoRN

Delirium in Hospitals Overlooked

If you’ve ever visited a family member or friend in the hospital it is an overwhelming emotional scene with the amount of machinery, loud constant noises, code calls over the intercom, and staff going in and out of the room. Not to mention the increase concern you have for your loved one, it can make anyone one in their right mind go delirious for that brief moment. Now imagine being one of those patients, critically ill, in bed most of the day where their physical, emotional, and mental abilities that have become altered. It came to my surprise that over 7 million Americans out of about 36 million of hospital admissions have been affected by cases of delirium each year (Boodman, 2015)

Delirium is a “sudden disruption of consciousness and cognition marked by vivid hallucinations, delusions, and an inability to focus”. It occurs suddenly and typically fluctuates throughout the day. One patient mentioned his delirium being like nightmares, although he knew that he was in the hospital and was sick he could not awaken from this terrible reality even after 3 years of being discharged from the hospital (Anthony Rossum, 2014). Some patients with delirium can be agitated and combative while other are lethargic and inattentive (Boodman, S., 2015), which makes me wonder, how many patients I have worked with in the hospital, whom had these horrible experiences and were silent about it. It wasn’t until recently that delirium was recognized or understood said Dr. Wes Ely from Vanderbilt University. Nearly, two thirds of Ely’s patients from the ICU reported signs of delirium, which led to his research and developed successful protocols in improving care and decreasing delirium in over six well known hospitals. The main interventions he utilized were the following ICU measures, in acronym: “ABCDEF,” which includes: Assessing and managing pain, Both Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT), Choice of Sedation/Analgesia, Delirium Monitoring, Early Mobility and Family engagement which after these interventions studied over 50% of the drugs normally given for sedation were decreased or cut cold turkey, showing a 4 day decrease stay in the ICU, and decreasing mortality rate up to 15%.

If you get a chance, please watch the story of Anthony Russo delirium he explains in the video above, I am a loss of words what he experienced in the ICU. I believe it will help in opening the eyes of what can be reality for these patients we care for everyday, as well as identifying how the long term complications can even occur after their discharge home from the ICU.

The astonishing fact is researchers have estimated that about 40% of delirium cases are preventable, which surprises me that so many people are still experiencing this reality this last year 7 million cases, especially for those elderly whom are at higher risk due to their sensitivity receiving large doses of anti-anxiety drugs and narcotics.

Brain injury is preventable by lowering exposure to potent sedative meds and shortening the duration of delirium with assessment and monitoring with the ABCDEF method. Think about it, it costs more than 143 billion annually to care for such delirium patients due to their longer hospital stays and complications, more is needed to be done in these preventable cases to reach out to those whom needs us most. Educate yourself and follow such articles on assessment tools in detecting delirium in patients.

Here are some examples:

Confusion Assessment Method (CAM)

Delirium Assessment and Management



Boodman, S. (2015). The Overlooked Danger of delirium in Hospitals. The Atlantic Article. Published by Kaiser Public Health News. Retrieved from:

Landro, L. (2011). Informed patient: changing sedation status quo in the ICU.  Health BlogWall Street Journal. Retrieved from

Digital Trends in Nursing

Digital technology is exponentially growing in the healthcare setting, including its increase access into the community. New research studies are pinning down ways to utilize the advance technology available, such as in: mobile device apps detecting health effects on academic performance, EKG ambulatory monitor assessments reducing risk of strokes, to simple ear buds that detect heart rate and calories lost as well as other developing trends.

Raney Linck, MSN instructor from Minnesota school of Nursing, has created a blog based on digital trends occurring in nursing and healthcare. It was unique to view his outlook of creating such a blog, however the most recent post is fairly outdated, October of last year. One of his discussions was on mobile health apps (mHealth), being used in research to gather information on student’s overall health by just having the users cellphone in close proximity. Sensor data was collected and organized by the cellphone app installed known as, “StudentLife.” For example, the camera of a phone was able to tell when the lights were turned off in a room, detect the sleeping duration and amount of time a student was in a particular area. I never heard of such a study but it did intrigue my thoughts wondering how I, as a student, would rate among their study from my mental health effects in my academics and how I can improve it based on the data available. It also made me realize with this research how much work it must take to analyze all the data and who was responsible for that role.

It’s incredible how a software may collect accessible data by using a cellular app, however it takes a humans manual manipulation and labor to analyze. Linck brought up a good point, if we have all the data imaginable with increased use of mHealth apps or EKG ambulatory monitoring and other healthcare related vehicles who will analyze the data? Imagine the changes that can evolve if there was a new job description for this role, possibly RN’s to step up in this changing technologic era and utilize the data for improving outcomes in the community based on the set of identified problem areas.

Nursing will always have a necessity to become socially mindful with using newly updated software’s, applications and programs being used in their facility. Such as with documenting healthcare information in patient care for reimbursements from Medicare and Medicaid. Then there is nursing assessments logged on the computer that allow easy access to trends in patient data such as their labs or imaging, MD/RN progress notes providing a larger picture of the entire patient. It may play a con with documentation say if there is downtime/power outage, I believe not all paper charting should be excluded as we will  eventually need the reliable paper and pen practices in a critical event. The public has become more proactive in their care including the assistance of increased availability to their own medical records from home.

Another interesting study from an Australia, Concord Hospital are participating in this new technology advancement creating wristbands that record the patients vital signs including oxygen saturation which electronically sends to patients medical electronic record instantaneously. They plan to expand their line product to over 27 hospitals over the next three years, allowing benefits for safe and efficient patient care saving time and reducing human error (ANMJ, 2015). The information sought out during this search of the digital trends shows how technology can have meaningful use ensuring quality and safety while improving care communication and management.


ANMJ. (2015). New wristband technology streamlining patient care. Australian Nursing & Midwifery Journal23(1), 5.

Piscotty, R. , Kalisch, B. , & Gracey‐Thomas, A. (2015). Impact of healthcare information technology on nursing practice.Journal of Nursing Scholarship47(4), 287-293.

Linck, R. (2014, October 8). Digital trends in nursing. Retrieved September 7, 2015,   from

About Me

  Hello, name is Vannessa Barretto. I have lived in Oxnard throughout my entire life, except for one year in 2010-2011, came back for school but not for long…. It was a difficult decision for me to head back into school after graduating with my ADN from Ventura College this past year 2014. I have been going to college ever since high school graduation without any real break the last 8 years (hah I could’ve gotten a doctorate already). In 2010, I headed off to North Dakota being offered an athletic scholarship with collegiate softball. I took advantage of the scholarship and pushed my luck in nursing while being a full time student, employer,  and athlete traveling the U.S missing classes, didn’t work out the way I wanted it to. So came back home to save money and focus on school and my future career. I had played softball for 15 years straight, to add year round and it was a huge change for me that took some time to get use to. I realized all things happen for a reason and I couldn’t have been more thankful for how it all played out. Now since after graduating with my ADN, I have been working for Community Memorial Hospital in Ventura since last November working in the Medical-Surgical/Oncology Unit. The experience I gained from North Dakota doing a full year of nursing opened my mind set of what nursing can be, how the culture is so different even in the United States. As I gain more experience in the nursing field I plan to work in Public Health/Travel RN, possibly in a manager setting or work my way to a Nurse Practitioner in years to come. However with all this schooling taking longer than expected, I have been thinking of taking a break after our graduation this upcoming May. I would like to travel with partner in crime (whom you see in the picture below). Actually for the first time, I will be traveling outside of the country in a few months for a short period in time but as a glimpse of what is yet to come. Look forward to all your posts/responses. Ciao!..See you soon. Partner in crime