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Session Details

Patient and Caregiver Experiences of Delirium Recovery: Application of the Process of Completing a Literature Review

Track: Podium: Research

Session Number: S203
Date: Sun, May 31st, 2020
Time: 9:45 AM - 10:45 AM

Description:

Patient and Caregiver Experiences of Delirium Recovery: Application of the Process of Completing a Literature Review

Background. Delivery of evidence-based practice improves outcomes for patients. Appraisal of evidence identified through a review of the literature is a skill needed by orthopaedic nurses in order to improve patient outcomes through the development of evidence-based protocols. Using a recently completed literature review on patient and caregiver experiences of delirium, the presenter will guide listeners through the process of evidence appraisal and conclusions to inform evidence-based care.

Problem. Delirium is a common complication following surgery associated with serious adverse outcomes including increased disability, morbidity, and mortality. Challenges associated with delirium include increased costs and healthcare use, nursing management that ensures patient safety, and patient distress. Evidence regarding the experience of delirium and recovery from delirium is limited, with even fewer reports regarding the experience of family members who are present with a loved one while delirious. A better understanding of the experience of delirium is needed to inform evidence-based delivery of post-discharge care.

Purpose. This review explored patient and family member experiences of delirium and delirium recovery. The review aimed to explore and clarify how patients experience delirium, how they recover from delirium, how family members perceive the patient’s experience of delirium and delirium recovery.

Methodology. Relevant databases were searched using the following selection criteria: (1) peer-reviewed primary research, (2) examined the experience of delirium and/or recovery from delirium in older adults age 50 or older and/or informal caregiver experience of delirium and/or recovery from delirium in an older adult family member, and (3) published in the English language. Exclusion criteria were: (1) published prior to 2006, and (2) Articles with samples of patients with alcohol-related delirium. Each primary study was graded for evidence level using the American Association of Critical Care Nurses’ levels of evidence, which ranks evidence on a scale of A-M to ensure that evidence is valid and credible.

Results. A total of 6 articles were selected based on relevance to the purpose of the final review. Characteristics of patient experiences of delirium included psychological distress, hallucinations, confusion, fear of reoccurrence, sleep disturbances, perceptual disturbances, and feeling of being trapped. Words used by patients included “dreadful”, “horrifying”, “haunting”, and “felt like dying”. Caregiver experiences of a loved one with delirium included not being recognized by their loved one, feeling burdened, feeling distressed, and questioning if a family member with delirium is receiving the best possible care.

Limitations. This review examined patient and caregiver perceptions of experiences of delirium and recovery from delirium. Therefore, only qualitative studies were included in the sample of articles reviewed. The review was limited to published primary research articles, which did not include unpublished evidence, such as dissertations.

Conclusions. Delirium is not an isolated experience, it is shared with caregivers. Delirium may pose a multifaceted burden on caregivers. Delirium is not only distressing for the individual with delirium, but also for family members of those who had developed delirium. Patients and family members may lack knowledge regarding delirium and how to handle the symptoms.
Implications. The findings from this review provide insight into the experience of delirium and delirium recovery from the patient and a family member’s perspective. Delirium and recovery from delirium are distressing not only for patients but also for informal caregivers of patients who are recovering from delirium. Delirium is not an isolated experience, but a shared experience of patients and caregivers. Further research is needed to identify effective interventions to support patients and their caregivers through the experience of delirium and recovery.
Sub-Categorization: Complications, Safety, Vulnerable Populations Best Practices
Session Type: Podium

Learner Outcome: The participant will apply the information regarding the appropriate use of evidence to inform change to improve evidence-based care.
Category: B
Sub-Categorization: Complications, Safety, Vulnerable Populations Best Practices
Session Type: Podium

Learner Outcome: The participant will apply the information regarding the appropriate use of evidence to inform change to improve evidence-based care.
Category: B

Speakers

Lead Presenter
Dawn L Denny, PhD, RN, ONC
University of North Dakota

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