TY - JOUR
T1 - Pilot study of a two-step delirium detection protocol administered by certified nursing assistants, physicians, and registered nurses
AU - Fick, Donna M.
AU - Inouye, Sharon K.
AU - McDermott, Caroline
AU - Zhou, Wenxiao
AU - Ngo, Long
AU - Gallagher, Jackie
AU - McDowell, Jane
AU - Penrod, Janice
AU - Siuta, Jonathan
AU - Covaleski, Thomas
AU - Marcantonio, Edward R.
N1 - Funding Information:
Dr. Fick is Elouise Ross Eberly Endowed Professor, Ms. McDermott is Doctoral Student and Robert Wood Johnson Scholar, and Dr. Penrod is Professor and Interim Dean, College of Nursing, The Pennsylvania State University, University Park, Pennsylvania; Dr. Inouye is Director, Dr. Ngo is Associate Professor of Medicine and Biostatistics, and Dr. Marcantonio is Professor of Medicine, Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, and Dr. Inouye is also Professor of Medicine, Mr. Zhou is Biostatistician, and Ms. Gallagher is Clinical Research Specialist, Division of General Medicine and Primary Care, and Dr. Ngo is also Associate Professor of Medicine and Biostatistics, and Dr. Marcantonio is also Professor of Medicine and Section Chief for Research, Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; and Dr. Siuta is Hospitalist, and Dr. Covaleski is Hospitalist, Mount Nittany Physician Group, Mount Nittany Medical Center, State College, Pennsylvania. †Deceased. This work was supported by the National Institute on Aging (NIA) (grants R01AG030618 and K24AG035075 [E.R.M.] and R24AG054259, P01AG031720, R01AG044518, and K07AG041835 [S.K.I.]). Dr. Fick is partially supported by the NIA (grant R01AG030618) and National Institute of Nursing Research (grant R01NR01104). The funding agencies had no role and the authors retained full autonomy in the preparation of this article. The remaining authors have no conflicts of interest, financial or otherwise. Dr. Fick was not involved in the peer review or decision-making process for this manuscript.
Publisher Copyright:
© SLACK Incorporated.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - The feasibility and acceptability of a twostep screening protocol for delirium identifi cation was pilot tested. Step 1, a screening tool, comprises two items: "Please tell me the day of the week," and "Please tell me the months of the year backwards starting with December." If either/both items are incorrect, Step 2, a 3-minute diagnostic assessment, follows. Trained researchers enrolled 24 hospitalized older adults and identifi ed 22% to be delirious after a reference standard assessment. Thereafter, physicians and RNs completed the two-step protocol, whereas certifi ed nursing assistants (CNAs) completed the screener only, on the same patients. All three clinical assessments were successfully completed in 100% of enrolled participants and within the target 2-hour time window in 91%. The screener and two-step protocol achieved high sensitivities and specifi cities in RNs, CNAs, and physicians. Qualitative information on barriers to and facilitators of implementation was also collected. Nurses and other clinicians can feasibly implement this ultra- brief screener and two-step protocol, which holds promise to improve delirium identifi cation. [Journal of Gerontological Nursing, 44(5), 18-24.].
AB - The feasibility and acceptability of a twostep screening protocol for delirium identifi cation was pilot tested. Step 1, a screening tool, comprises two items: "Please tell me the day of the week," and "Please tell me the months of the year backwards starting with December." If either/both items are incorrect, Step 2, a 3-minute diagnostic assessment, follows. Trained researchers enrolled 24 hospitalized older adults and identifi ed 22% to be delirious after a reference standard assessment. Thereafter, physicians and RNs completed the two-step protocol, whereas certifi ed nursing assistants (CNAs) completed the screener only, on the same patients. All three clinical assessments were successfully completed in 100% of enrolled participants and within the target 2-hour time window in 91%. The screener and two-step protocol achieved high sensitivities and specifi cities in RNs, CNAs, and physicians. Qualitative information on barriers to and facilitators of implementation was also collected. Nurses and other clinicians can feasibly implement this ultra- brief screener and two-step protocol, which holds promise to improve delirium identifi cation. [Journal of Gerontological Nursing, 44(5), 18-24.].
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U2 - 10.3928/00989134-20180302-01
DO - 10.3928/00989134-20180302-01
M3 - Article
C2 - 29596707
AN - SCOPUS:85046264638
SN - 0098-9134
VL - 44
SP - 18
EP - 24
JO - Journal of Gerontological Nursing
JF - Journal of Gerontological Nursing
IS - 5
ER -