在急诊部 (ED) 改进痴呆症查和检测:ED痴呆症检测计划的实施和评估
Liron Sinvani1,2,3, Alexandra Perrin3,4, Amy G Huebschmann5
1Northwell Health, New Hyde Park, New York, USA.
概括
随着ED Delirium检测计划 (ED-DDP) 的实施,老年人痴呆症的检测得到了改善,但总体检测率仍然很低. 可持续的策略需要集成的工作流程和清晰的后检测行动超出初始培训.
科学领域:
- 老年学是一门学科.
- 紧急医疗 紧急医疗
- 临床实施科学 临床实施科学
背景情况:
- 在急诊室 (ED) 中,老年人经常错过 Delirium,这会影响患者的治疗结果.
- 错过的妄想诊断的流行程度突出了老年人群的紧急护理中的关键差距.
研究的目的:
- 评估ED Delirium检测计划 (ED-DDP) 在提高痴呆症检测率方面的有效性.
- 通过RE-AIM框架在各种ED环境中评估ED-DDP的实施结果.
主要方法:
- 为了实施ED-DDP,在3个ED中进行了一项阶梯集群随机试验.
- 该计划采用了培训培训师模式,授权妄冠军 (DC) 通过EHR培训护士进行bCAM查.
- 量化和定性方法评估了覆盖范围,有效性,采用,实施和维护结果.
主要成果:
- 在实施后, Delirium 查几率增加了 11.5 倍 (p < 0.001), 查率在不同地点 (6% - 80%) 之间有显著差异.
- 阳性妄想屏幕的比例从0%上升到2.2% (p = 0.002),表明疗效有所改善.
- 观察到高培训完成率和护士采用率,但忠诚度得分平均为73.3%,竞争优先事项成为维护障碍.
结论:
- ED-DDP成功地提高了ED中妄想查频率.
- 尽管查得到了改进,但总体检测率较低表明,单独的培训不足以持续改善.
- 有效的妄想检测需要集成的工作流程解决方案和在ED中建立后检测管理途径.
相关概念视频
01:27Emerging Adulthood
718
Jeffrey Arnett's concept of emerging adulthood offers a framework to understand the unique developmental stage between adolescence and full-fledged adulthood, generally from ages 18 to 25. This period is marked by extensive exploration and shifts in identity, relationships, and career choices, a process known in psychology as role experimentation. Emerging adulthood reflects the evolving cultural expectations surrounding adulthood and the dynamic process of personal transformation during...
718
01:00Detection of Gross Error: The Q Test
7.0K
When one or more data points appear far from the rest of the data, there is a need to determine whether they are outliers and whether they should be eliminated from the data set to ensure an accurate representation of the measured value. In many cases, outliers arise from gross errors (or human errors) and do not accurately reflect the underlying phenomenon. In some cases, however, these apparent outliers reflect true phenomenological differences. In these cases, we can use statistical methods...
7.0K
01:10Detection of Black Holes
2.6K
Although black holes were theoretically postulated in the 1920s, they remained outside the domain of observational astronomy until the 1970s.
Their closest cousins are neutron stars, which are composed almost entirely of neutrons packed against each other, making them extremely dense. A neutron star has the same mass as the Sun but its diameter is only a few kilometers. Therefore, the escape velocity from their surface is close to the speed of light.
Not until the 1960s, when the first neutron...
Their closest cousins are neutron stars, which are composed almost entirely of neutrons packed against each other, making them extremely dense. A neutron star has the same mass as the Sun but its diameter is only a few kilometers. Therefore, the escape velocity from their surface is close to the speed of light.
Not until the 1960s, when the first neutron...
2.6K
01:15Nursing Implementation
6.2K
Implementation is the execution of the nursing care plan developed during the planning phase.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
6.2K
01:05Difference from Background: Limit of Detection
8.4K
The limit of detection (LOD) is the smallest amount of analyte that can be distinguished from the background noise. The LOD value corresponds to the concentration at which the analyte signal is three times larger than the standard deviation of the blank signal. Below this value, the analyte signal cannot be differentiated from the background noise. It is calculated by dividing the calibration slope by 3 times the standard deviation of the blank signals.
The LOD indicates the presence or absence...
The LOD indicates the presence or absence...
8.4K
01:18Effects of EDTA on End-Point Detection Methods
667
Different methods, such as visual observance of metal-ion indicators, spectroscopic techniques, and potentiometric methods, can determine the endpoint of an EDTA titration.
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a...
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a...
667