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Patient Factors That Influence Reliable Delirium Assessments in a Medical Intensive Care Unit During the Routine Clinical Practice

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Listed:
  • Ji-Sun Back
  • Taixian Jin
  • Huiying Jin
  • Sun-Mi Lee

Abstract

This study aimed to determine patient and therapeutic characteristics of patients in the medical intensive care unit (MICU) that contribute to inconsistent results of delirium assessments performed during routine clinical practice. Therefore, electronic health records were reviewed and compared with secondary data collected from the same medical ICU patients who were assessed using the Confusion Assessment Method in the ICU (CAM-ICU). Of 5,241 cases involving 762 patients, 827 (15.78%) cases showed disagreement between assessments. Continuous renal replacement therapy, physical restraint use, and altered mental status were factors that increased the likelihood of inconsistencies between assessments. A significant positive correlation was found between the CAM-ICU disagreement rate and the total number of assessments per month. To maximize the reliability of delirium assessments, individual-targeted approaches considering the patient’s level of consciousness and type of treatment implemented are required, along with ensuring a stable, and regulated working environment and customized educational programs.

Suggested Citation

  • Ji-Sun Back & Taixian Jin & Huiying Jin & Sun-Mi Lee, 2023. "Patient Factors That Influence Reliable Delirium Assessments in a Medical Intensive Care Unit During the Routine Clinical Practice," Clinical Nursing Research, , vol. 32(4), pages 742-751, May.
    • Handle: RePEc:sae:clnure:v:32:y:2023:i:4:p:742-751
    DOI: 10.1177/10547738211058983
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    References listed on IDEAS

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    1. Angela Teece & John Baker & Helen Smith, 2020. "Identifying determinants for the application of physical or chemical restraint in the management of psychomotor agitation on the critical care unit," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(1-2), pages 5-19, January.
    2. Yoo‐Sol An & Yinji Jin & Taixian Jin & Eun Young Hur & Sun‐Mi Lee, 2019. "Operative and anaesthetic factors influencing on delirium in the intensive care unit: An Analysis of electronic health records," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(7-8), pages 1327-1335, April.
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