Evaluation of the delirium early monitoring system (DEMS).
Int Psychogeriatr
; 28(11): 1879-1887, 2016 11.
Article
in En
| MEDLINE
| ID: mdl-27443322
ABSTRACT
BACKGROUND:
Despite awareness of the negative health and financial outcomes of delirium, systems to routinely assess and manage the condition are absent in clinical practice. We report the development and pilot evaluation of a Delirium Early Monitoring System (DEMS), designed to be completed by non-medical staff to influence clinical processes within inpatient settings. Two versions of the DEMS are described based on a modified Confusion Assessment Method (DEMS-CAM) and Delirium Observation Screening Scale (DEMS-DOSS).METHODS:
Both versions of DEMS were piloted on a 20-bedded Psychogeriatric ward over 6 weeks. Training was administered to ward staff on the use of each version of the DEMS and data were collected via electronic medical records and completed assessment sheets. The primary outcome was patterns of DEMS use and the secondary outcome was the initiation of delirium management protocols. Data regarding the use of the DEMS DOSS and DEMS CAMS were analyzed using χ 2 tests.RESULTS:
Completion rates for the DEMS CAM and DEMS DOSS were 79% and 68%, respectively. Non-medical staff were significantly more likely to use the DEMS-CAM as part of daily practice as opposed to the DEMS-DOSS (p<0.001). However, there was no difference between the use of the DEMS-CAM and DEMS-DOSS in triggering related actions such as documentation of assessment scores in patients' medical records and implementation of delirium management protocols.CONCLUSIONS:
This real world evaluation revealed that non-medical staff were able to incorporate delirium monitoring into their practice, on the majority of occasions, as part of their daily working routine. Further research is necessary to determine if the routine use of the DEMS can lead to improved understandings and practice of non-medical staff regarding delirium detection.Key words
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Confusion
/
Delirium
/
Early Diagnosis
/
Behavior Observation Techniques
/
Inpatients
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Screening_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
Int Psychogeriatr
Journal subject:
GERIATRIA
/
PSIQUIATRIA
Year:
2016
Document type:
Article
Affiliation country:
United kingdom