PROBLEMS ASSOCIATED WITH UNDERRECOGNITION OF DELIRIUM IN CRITICAL CARE - A CASE-STUDY

Delirium, a syndrome that results in high morbidity and mortality rate s in the elderly, continues to be underrecognized by physicians and nu rses. Factors influencing the underrecognition of delirium are specifi c to individual institutions and their health care providers. The fact ors leading to the underrecognition of delirium must be identified so that changes can be made to increase early recognition, A case study c onducted in a critical care unit in a midwestern hospital from intervi ews of nurses, chart audit, and patient observation, identified two ma jor problems associated with the lack of recognition of delirium in th at institution: (1) lack of knowledge on the part of nurses about the criteria and methods of detecting delirium, and (2) ineffective commun ication between all staff members in relaying symptoms of onset of the disorder. As a result of this study staff education, assessment proto cols, and improved communication and documentation techniques are indi cated as targeted methods for improving recognition and treatment of d elirium in this setting. Similar case studies can be performed to eval uate instittutional practice, and thereby identify barriers to early r ecognition of delirium.