Delirium Prevention and Treatment

Classmate 2: The area of interest I have selected for this research project is about delirium prevention and treatment more specifically, within the postoperative setting. Delirium is an acute disruption of normal cognitive function and includes inability to pay attention, fluctuating consciousness, and disorganized thinking (Reddy et. al, 2017). Delirium can have significant consequences, especially in the elderly population, which include increased length of stay, impaired recovery, and increased mortality (Reddy et. al, 2017). Because of the profound adverse outcomes delirium has on recovery and overall patient outlook, it is imperative that the risk of developing delirium is assessed and preventative measures and treatments are employed.

In conducting an evidence-based research review from the Agency of Healthcare Research and Quality, there is actually limited evidence about screening and prevention of postoperative delirium. Interestingly enough, even though delirium is a widespread concern for hospitalized patients, there was only one report listed. The report focused on antipsychotics for the prevention and treatment of delirium. Neufeld et. al (2019) published a report which examined the use of antipsychotic treatment for the prevention of delirium among patients aged 65 and older among various hospital settings including the ICU, postoperative setting, acute care, and palliative care. The recommendations outlined that the use of antipsychotic medications such as Haldol, did not decrease length of hospital stay or decrease the severity of delirium (Neufeld et. al, 2019). The evidence is currently relatively weak concerning the use of antipsychotic treatments for patients experiencing delirium.

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Concerning the postoperative population, it was found that second generation antipsychotics may be beneficial in preventing delirium in vulnerable populations, although the author does disclose that this evidence is limited (Neufeld et. al, 2019). There was little evidence that the treatment with any antipsychotic decreased the length of stay, there was also insufficient evidence that the treatment with antipsychotics decreased the severity of the delirious episode, or had any effect on risk of falls while hospitalized (Neufeld et. al, 2019). The evidence based on this report is more or less inconclusive about the use of antipsychotics for the prevention and treatment of delirium in elderly patients, despite the fact that the review was scoping and included patients admitted in a variety of clinical settings. Given these current recommendations, it is clear that more research should be conducted, or a review of other elements of delirium treatment and prevention. For the research proposal, I hope to conduct a review based on delirium screening within the perioperative period to establish evidence for preventative measures amongst the elderly surgical population.

As Christian nurses, we are called to the challenge of utilizing critical thinking skills and synthesizing new research into actionable protocols in order to benefit our patients. Proverbs 18:15 states, “an intelligent heart acquires knowledge, and the ear of the wise seeks knowledge” (English Standard Version Bible, 2001). The Bible teaches us to continually seek knowledge, and it is our duty as nurses and as educators, to rise to the challenge of the frequently changing healthcare climate in order to provide the best care possible.


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