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. 2012 Jan;38(1):32-42.
doi: 10.3928/00989134-20110706-01. Epub 2011 Jul 15.

Delirium superimposed on dementia: accuracy of nurse documentation

Melinda R Steis  1 , Donna M Fick
Affiliations

Delirium superimposed on dementia: accuracy of nurse documentation

Melinda R Steis et al. J Gerontol Nurs. 2012 Jan.

Abstract

Delirium is an acute, fluctuating confusional state that results in poor outcomes for older adults. Dementia causes a more convoluted course when coexisting with delirium. This study examined 128 days of documentation to describe what nurses document when caring for patients with dementia who experience delirium. Nurses did not document that they recognized delirium. Common descriptive terms included words and phrases indicating fluctuating mental status, lethargy, confusion, negative behavior, delusions, and restlessness. Delirium is a medical emergency. Nurses are in need of education coupled with clinical and decisional support to facilitate recognition and treatment of underlying causes of delirium in individuals with dementia.

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Figures

Figure
Figure
Illustration of the process detailing the transition from 138 participants in the parent study to the 104 participants in the chart audit. Note. CAM = Confusion Assessment Method (Inouye et al., 1990); DSD = delirium superimposed on dementia; EMR = electronic medical record.
See this image and copyright information in PMC

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