RESUMEN
Delirium is a common neurocognitive disorder prevalent in hospitalized older adults. The development of delirium is associated with adverse health outcomes, including functional decline and mortality. This study aimed to investigate the incidence and risk factors of postoperative delirium in older adults (≥60 years) who underwent orthopaedic surgery. Elderly orthopaedic patients were recruited from a large urban hospital over 12 months. Patients were preoperatively screened for delirium and followed up at least once daily postoperatively until discharge. Of the 124 patients in the sample, 21 (16.9%) had postoperative delirium. There were no significant differences in any of the baseline characteristics between the delirious and nondelirious patients. Patients using antidepressants were more likely to develop postoperative delirium compared with those not using antidepressants (odds ratio: 2.72, p = .05). Postoperative delirium was common in this sample of older adults who underwent orthopaedic surgery. Aiming prevention strategies toward patients using antidepressants may help reduce the incidence of delirium in this population.
Asunto(s)
Delirio/epidemiología , Modelos de Enfermería , Procedimientos Ortopédicos/efectos adversos , Complicaciones Posoperatorias/etiología , Anciano , Anciano de 80 o más Años , Delirio/etiología , Femenino , Humanos , Incidencia , Masculino , Alta del Paciente , Factores de RiesgoRESUMEN
The current quality improvement study aimed to determine hearing loss (HL) prevalence in older adult patients in a large urban hospital, and the success of current processes to identify its presence during routine admission procedures. Predictors of HL were also evaluated, with the goal of identifying risk factors that might help staff anticipate patient communication challenges. A sample of 162 newly admitted patients, age 70 and older, participated in a hearing/communication assessment that included audiometry and an informal self-report measure about hearing difficulty. Chart review was conducted to assess whether patients with confirmed hearing/communication deficits had been identified as such during the admission or nursing assessments. Results revealed a high prevalence of HL (72.8%) and relatively low sensitivity of routine admission procedures in identifying this communication deficit (14.4% to 43.2%). Age and male gender were found to be predictors of HL. The invisibility of HL poses a challenge to nurses in recognizing when older adult patients are at risk for communication breakdowns. Communication breakdowns associated with HL can potentially impact patients' adherence to treatment plans. [Journal of Gerontological Nursing, 46(6), 34-42.].
Asunto(s)
Pérdida Auditiva/epidemiología , Hospitalización/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Audiometría , Comunicación , Femenino , Hospitales Urbanos , Humanos , Masculino , Pennsylvania/epidemiología , Prevalencia , Mejoramiento de la Calidad , AutoinformeRESUMEN
As age increases, the prevalence of hearing loss significantly increases, reaching up to 89% of those 80 years and older. Hearing loss in older patients is often unrecognized and its consequences are often underappreciated. Hearing loss can interfere with the ability to exchange important health information and to participate in health care decision-making. Hearing loss during hospitalization increases the risk of misdiagnosis. There is a lack of empirical data regarding prevalence and recognition of hearing loss in hospitalized older adults. In this article, we describe a variety of negative outcomes that may result when older inpatients are functioning with unrecognized hearing loss.