Laurente, Ana BSN-1 Block 2 January 22, 2019

NURSING ASSESSMENT AS AN EFFECTIVE TOOL FOR THE IDENTIFICATION OF

DELIRIUM RISK IN OLDER IN-PATIENTS: A CASE–CONTROL STUDY

Synthesis:
This case-control study conducted last 2017 by nurse researchers from Spain is
entitled: Nursing Assessment as an Effective Tool for the Identification of Delirium Risk
in Older In-Patients: A Case–Control Study. The researchers determined numerous
assessments and prediction of risk of delirium but only a few of them are known and are
currently used by medical professionals. Knowledge of delirium by doctors and nurses
is presently in continuous research for further study. Their primary objective is to
evaluate the usefulness of comprehensive nursing assessment as a strategy for
determining the risk of delirium in older in-patients from a model of care needs based on
variables easily measured by nurses.

 Delirium is common in hospitalized older adults and is known to increase the risk
for subsequent functional decline and mortality. The pathophysiology is not fully
understood, but delirium may be due to inflammatory mechanisms and a cholinergic
neurotransmitter deficiency in the brain. During acute illness, older patients are at risk of
delirium due to a decreased cognitive reserve.  Ideally, non-pharmacological strategies
should be used to address six risk factors that contribute to delirium: cognitive
impairment, sleep deprivation, immobility, visual impairment, hearing impairment, and
dehydration.

Based on literatures about delirium and Virginia Henderson’s nursing care needs,
the researchers designed a specific form to collect data from their 454 in-patients and
they also used the data from the patients’ electronic clinical records. After analyzing the
data using numerous statistical techniques, the results showed that comprehensive
nursing assessment is a valid and consistent strategy with a multifactorial model of
delirium, which enables the personalized risk assessment necessary to define a plan of
care with specific interventions for each patient. In conclusion, nursing assessment is a
useful component in the risk assessment of delirium and one that is necessary for
developing an individualized care regime.