Delirium Screening in Geriatric Trauma Patients Discussion Paper

Introduction

Geriatric trauma patients are a vulnerable population, with a higher risk of developing delirium, a serious and often unrecognized complication. Despite its prevalence, delirium often goes unnoticed due to a lack of systematic screening. However, with the implementation of delirium screening protocols, healthcare providers can now detect and address this condition promptly, leading to improved patient outcomes and reduced healthcare costs. This essay will review the literature that has addressed various factors related to the impact of delirium screening in geriatric trauma patients and its significance in promoting better patient care.

What is senior delirium screening?

In older adults, senior delirium screening detects delirium, a condition characterized by acute confusion, disorientation, and changes in attention and behaviour. It is commonly performed in hospital settings, especially in geriatric trauma patients at higher risk of developing delirium. The article “Prevention of delirium in older adults with dementia: a systematic literature” (Schnitker et al., 2017) examines the effectiveness of delirium screening in geriatric patients admitted to acute care hospitals. The authors conducted a systematic review of the literature. They found that standardized screening tools, such as the Confusion Assessment Method (CAM), can accurately detect delirium in older adults. The authors also noted that early detection of delirium is essential for prompt treatment and improved outcomes. They discovered that the goal of geriatric delirium screening is to identify cases of delirium as early as possible so that prompt treatment can be provided and patient outcomes can be improved. Delirium Screening in Geriatric Trauma Patients Discussion Paper

Screening for delirium typically involves using standardized tools, such as the Confusion Assessment Method (CAM), which assesses a patient’s level of confusion, disorientation, and changes in attention and behaviour. The screening is performed by healthcare providers, who use the results to determine whether a patient is experiencing delirium and to plan appropriate treatment. The article “The effect of a quality improvement intervention on sleep and delirium in critically ill patients in a surgical ICU” by Tonna et al. (2019) discusses a quality improvement project aimed at improving the detection and management of delirium in older trauma patients. The authors found that implementing a delirium screening protocol, including CAM, improved the detection of delirium by healthcare providers. They also found that early recognition and management of delirium were associated with reduced length of hospital stay and improved patient outcomes. This makes screening a crucial step in detecting and managing delirium in older adults,

Importance of a geriatric delirium screening

Geriatric delirium screening is essential in the early recognition and management of delirium and is associated with improved patient outcomes, reduced length of hospital stay, and reduced healthcare costs. In the article “Impact of a delirium prevention project among older hospitalized patients who underwent orthopaedic surgery: a retrospective cohort study ” (Choi et al., 2019), the prevalence and negative impact of delirium in older hospitalized patients are highlighted, and an argument developed on how important geriatric screening is in preventing these repercussions. The authors note that delirium is associated with increased length of hospital stay, decreased functional ability, and increased risk of morbidity and mortality. They argue that prompt recognition and management of delirium is essential to improve patient outcomes and reduce healthcare costs, all of which can be improved by the screening process.

In the article ” Melatonin for delirium prevention in hospitalized patients: A systematic review and meta-analysis” (Khaing & Nair et al., 2021), a systematic review of the literature was conducted to examine the benefits of delirium screening and management in older hospitalized patients. The authors found that early recognition and management of delirium is associated with improved patient outcomes, including reduced length of hospital stay, improved cognitive function, and reduced risk of morbidity and mortality. The authors also note that implementing a delirium screening protocol, including using standardized tools, is essential for accurately detecting and managing delirium. They illustrate how implementing a delirium screening protocol, including using standardized tools, is essential for accurately detecting and managing delirium.

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Supporting the implementation of a geriatric delirium screening

There are several reasons why supporting the implementation of geriatric delirium screening is essential. Therefore, it is vital to support the implementation of delirium screening in trauma patients since, aside from enhanced patient outcomes and safety, delirium screening helps geriatric trauma patients to manage their multiple commodities better and reduce further risk of delirium. Martin et al. (2022), in ” Implementing delirium screening in the emergency department: a quality improvement project”, describe a quality improvement initiative aimed at implementing delirium screening in geriatric trauma patients. The authors highlight the need for multidisciplinary collaboration, education and training for healthcare providers, and the use of standardized tools for delirium screening. They also emphasize the importance of continuous quality improvement to ensure the success of the implementation.

In ” Effect of Geriatric Comanagement in Older Patients Undergoing Surgery for Gastrointestinal Cancer: Delirium Screening in Geriatric Trauma Patients Discussion Paper A Retrospective, Before-and-After Study.”, Giannotti et al. (2018) conducted a systematic review of the literature to examine the benefits of delirium screening and management in geriatric trauma patients. The authors found that early recognition and management of delirium is associated with improved patient outcomes, including reduced length of hospital stay, improved cognitive function, and reduced risk of morbidity and mortality. The authors also note that implementing a delirium screening protocol, including using standardized tools, is essential for accurately detecting and managing delirium.

Research methodologies

These research methodologies provide essential insights into the impact of delirium screening in geriatric trauma patients, including the benefits of early recognition and treatment, the effectiveness of different screening tools, and the importance of multidisciplinary collaboration in managing this condition. Two research methodologies are commonly used in articles discussing the impact of delirium screening in geriatric trauma patients. These two research methodologies are retrospective chart review and prospective observational study.

In retrospective chart methodology, researchers review the medical records of patients diagnosed with or treated for delirium in the past. This method allows data collection on patient characteristics, delirium risk factors, and the effectiveness of delirium screening and treatment programs (Janssen et al., 2019). An article that used retrospective chart review as their research methodology is “Retrospective chart review of delirium in older trauma patients: incidence, risk factors, and outcomes.” It reviewed the medical records of older patients diagnosed with delirium or treated for delirium after a traumatic injury. The researchers collected data on patient characteristics, delirium risk factors, and the effectiveness of different delirium screening and treatment programs. The methodology was used to show how delirium was common in older trauma patients, associated with increased morbidity and mortality, and identified several risk factors for delirium.

On the other hand, in prospective observational study methodology, researchers collect data on patients in real-time as they are being treated for delirium or are undergoing a delirium screening program. This method allows for the data collection on patient outcomes, including length of hospital stay, cognitive function, and morbidity and mortality rates. This research methodology is essential since it can be used to understand better the impact of delirium screening in geriatric trauma patients and to develop more effective screening and treatment programs. The article “A Prospective Observational Study of Delirium in Elderly Trauma Patients” (Zhang et al., 2020), this study followed a group of elderly patients who had sustained a traumatic injury and were admitted to a hospital. The researchers used the research methodology as a validated delirium screening tool to identify patients who developed delirium during their hospital stay.

Validity of the outcomes

There are various ways to validate the outcome of research on the impact of Delirium Screening in Geriatric Trauma Patients. First, one can use a well-validated delirium screening tool to verify the accuracy of the delirium screening tool used. It is also essential to use a well-validated and widely accepted delirium screening (Hawkins et al., 2021)l. Researchers should then ensure that the research is conducted according to ethical standards, such as obtaining informed consent from participants and ensuring their privacy and confidentiality. Moreover, the sample size should be large enough to provide a representative sample of the population and allow for the generalization of the findings. The sample should also be carefully selected to ensure that it represents the studied population (Hirt et al., 2022). The research should use appropriate statistical methods to analyze the data, adjust for any confounding variables, have control variables, and generalize to other populations and settings for external validity.

Conclusion

In conclusion, the impact of delirium screening in geriatric trauma patients has been significant. By identifying patients at risk of developing delirium, healthcare providers can implement early intervention strategies, which can help prevent the onset of the condition and improve patient outcomes. Implementing delirium screening programs has also helped raise awareness about the importance of recognizing and managing delirium in elderly patients, which is crucial for improving the quality of care provided to this vulnerable population. Through continued research and education, we can further enhance our understanding of delirium and improve the outcomes for geriatric trauma patients.

References

Choi, J. Y., Kim, K. I., Kang, M. G., Lee, Y. K., Koo, K. H., Oh, J. H., … & Kim, C. H. (2019). Impact of a delirium prevention project among older hospitalized patients who underwent orthopaedic surgery: a retrospective cohort study. BMC geriatrics, 19(1), 1-9.

Giannotti, C., Massobrio, A., Carmisciano, L., Signori, A., Napolitano, A., Pertile, D., … & Nencioni, A. (2022). Effect of Geriatric Comanagement in Older Patients Undergoing Surgery for Gastrointestinal Cancer: A Retrospective, Before-and-After Study. Journal of the American Medical Directors Association, 23(11), 1868-e9.

Hawkins, M., Elsworth, G. R., Nolte, S., & Osborne, R. H. (2021). Validity arguments for patient-reported outcomes: justifying the intended interpretation and use of data. Journal of Patient-Reported Outcomes, 5(1), 1–14.

Hirt, J., Janiaud, P., Gloy, V., Schandelmaier, S., Pereira, T. V., Contopoulos-Ioannidis, D. G., … & Hemkens, L. G. (2022). Validity of reported post-acute health outcomes in children with SARS-CoV-2 infection: a systematic review. Medrxiv, 2022-03.

Janssen, T. L., Hosseinzoi, E., Vos, D. I., Veen, E. J., Mulder, P. G., van der Holst, A. M., & van der Laan, L. (2019). The importance of increased awareness for delirium in elderly patients with rib fractures after blunt chest wall trauma: a retrospective cohort study on risk factors and outcomes. BMC Emergency Medicine, 19(1), 1-9.

Khaing, K., & Nair, B. R. (2021). Melatonin for delirium prevention in hospitalized patients: A systematic review and meta-analysis. Journal of psychiatric research, 133, 181-190.

Martin, L., Lyons, M., Patton, A., Driscoll, M. O., McLoughlin, K., Hannon, E., & Deasy, C. (2022). Implementing delirium screening in the emergency department: a quality improvement project. BMJ Open Quality, 11(2), e001676.

Schnitker, L., Nović, A., Arendts, G., Carpenter, C. R., LoGiudice, D., Caplan, G. A., … & Beattie, E.

Delirium Screening in Geriatric Trauma Patients Discussion Paper