Prevention and monitoring of delirium in older adults: an educational intervention

Faustino, Tássia Nery; Pedreira, Larissa Chaves; Freitas, Yasmin Seixas de; Silva, Rosana Maria de Oliveira; Amaral, Juliana Bezerra do

doi:10.1590/0034-7167.2016690416i

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

RESEARCH • Rev. Bras. Enferm. 69 (4) • Jul-Aug 2016 • https://doi.org/10.1590/0034-7167.2016690416i copy

Prevention and monitoring of delirium in older adults: an educational intervention

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to conduct an educational intervention with the nursing team members of an intensive care unit (ICU), aiming to increase knowledge and to introduce improvements in their practices regarding prevention and monitoring of delirium in older patients.

Method:

this is an action research, in which workshops were conducted with eleven nurses and a nursing technician from an ICU unit in Salvador, Bahia, Brazil.

Results:

ten problems regarding nursing practices for prevention and monitoring of delirium were identified. Educational, practical, technical, and managerial actions were planned, involving cross-sector connections for planning ways to solve these problems. The groups reported significant changes in the practices, with the implementation of drug-free measures for preventing and managing the situation.

Conclusion:

the educational intervention contributed to improve the nursing practices in the ICU unit studied, and it also favored the development of critical thinking about the problems mentioned, thus enabling permanent review of offered treatments.

Descriptors:
Delirium; Dementia; Amnestic Disorder, and Other Cognitive Disorders; Older adults; Nursing Team

Detected problems	Required actions for solving/planning solutions for them
Lack of team sensitization regarding the care to older adults under the risk of delirium and the ones suffering from it.	To promote a seminar on the topic; to invite a research group member to expose the data collected from delirium patients in the studied ICU; to disseminate the seminar topics to the nursing team: to prepare an information poster and to promote oral information.
Patients’ difficulty in visualizing clocks.	To check for the possibility of purchasing another three clocks for the unit; to check with the engineering/maintenance service for the possibility of installing the clocks on the walls.
Insufficient guidance for patients by the professionals.	To inform/sensitize the team about the importance of periodically providing guidance to patients: seminar; to include periodically giving patients instructions/ stimulating the memory of patients in the list of nursing duties.
Insufficient communication between professionals and family members.	To inform/sensitize the nursing team on the importance of providing patient families with information regarding the condition of delirium; to include information on delirium in the “Visitor’s Guide” booklet, as follows: what is and how to prevent it; to prepare an informational poster on delirium: what is; what it causes; how to identify it; how to prevent it.
Absence of routines for allowing the use of hearing aids, glasses, and dentures.	To inform/sensitize the team on the importance of avoiding sensory deprivation: seminar; to establish flexible routines for patients to use hearing aids, glasses, and dentures, according to their clinical condition; to check for the availability of plastic boxes for storing dentures. As a second alternative, using plastic bags.
Improper material for physical restraint of patients.	To contact the responsible group, to check for the possibility of purchasing enough restraints for the unit; to contact the laundry department to determine the way to control (deliveries and returns) the restraints sent for being washed; to instruct the team regarding the use of control (deliveries and returns) of restraints.
Excessive nighttime lighting.	To check, with the maintenance department, for the possibility of separating the nursing station light switch from the one in the hall, and the feasibility of installing a dimmer in the nursing station; to check with the laundry/sewing department for the possibility of making eye patches.
Nighttime interruption of patients’ sleep.	To prepare a poster for informing/sensitizing the team on the importance of refraining from interrupting the patients’ sleep during the night; to check for the possibility of purchasing new axillary thermometer cables with the clinical engineering team; to stress the importance of adjusting oral, subcutaneous medications, and eye drops at 12 a.m., 2 a.m., and 4 a.m. to the nursing team, according to the clinical condition of patients.
Excessive noise in the unit.	To prepare and informational poster for informing/sensitizing the team on the importance of reducing noise; to establish a routine of keeping cell phones in vibrate mode during shifts; to check with the purchasing department for the possibility of acquiring earplugs.
Not using scales for detecting delirium.	To establish, as a routine, entering the description of patients’ mental health changes in the proper nursing forms; to train nurses on site for applying the CAM-ICU scale; to establish a routine for applying CAM-ICU scale once per day period (morning, afternoon, and NS) and whenever patients have acute mental state changes.

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] CORRESPONDING AUTHOR: Tássia Nery Faustino. E-mail: tassiafaustino@yahoo.com.br