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Recognizing delirium superimposed on dementia: assessing nurses' knowledge using case vignettes.

Donna M Fick1, Denise M Hodo, Frank Lawrence

  • 1School of Nursing, Pennsylvania State University, University Park 16802-6508, USA. dmf21@psu.edu

Journal of Gerontological Nursing
|February 22, 2007
PubMed
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Nurses struggle to identify delirium superimposed on dementia (DSD) in older adults, despite strong general knowledge. Educational programs are needed to improve recognition of DSD symptoms, particularly the hypoactive form.

Area of Science:

  • Geriatric Medicine
  • Geropsychiatric Nursing
  • Cognitive Impairment

Background:

  • Delirium is a common, serious condition in hospitalized older adults.
  • Delirium superimposed on dementia (DSD) involves concurrent delirium and pre-existing dementia.
  • DSD is frequently underrecognized by healthcare professionals, including nursing staff.

Purpose of the Study:

  • To assess nursing staff's ability to identify delirium superimposed on dementia (DSD).
  • To evaluate the correlation between general geropsychiatric nursing knowledge and DSD recognition.
  • To identify specific challenges in recognizing DSD in clinical scenarios.

Main Methods:

  • Utilized standardized case vignettes to present clinical scenarios.
  • Administered the Mary Starke Harper Aging Knowledge Exam (MSHAKE) to measure geropsychiatric knowledge.

Related Experiment Videos

  • Quantified nursing identification accuracy for DSD, dementia alone, and delirium alone.

    • Main Results:

    • Nurses demonstrated high general geropsychiatric knowledge per MSHAKE scores.
    • Significant difficulty was observed in identifying DSD compared to dementia or delirium alone.
    • Only 21% of nurses correctly identified hypoactive DSD; 41% identified hypoactive delirium alone.

    Conclusions:

    • A knowledge gap exists in nursing recognition of DSD, especially its hypoactive presentation.
    • Targeted interventions and educational programs are crucial to enhance nursing awareness of DSD.
    • Improving DSD identification can lead to better patient outcomes in older adults.