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Preoperative Cognition Screening and Postoperative Delirium in Older Surgical Patients
People 65 years or older are having surgery later in life and are at risk of developing a major postoperative complication, delirium. The Montreal Cognitive Assessment, is a preoperative cognitive screening tool which was used to screen thirty-three older orthopedic surgical patients to reduce the incidence of this serious postoperative complication. Patients who scored below normal were identified as at risk and monitored to ascertain if identification and monitoring influenced their postoperative course. At the first postoperative visit, each patient was evaluated for falls, confusion, and the ability to follow the required postoperative home exercise program to identify an undetected episode of delirium after discharge. Of the patients screened, 34.1% (n = 14) of patients fell below the cutoff for normal cognition. Subsequent monitoring and nursing interventions may have influenced their postoperative course as there were no reported episodes of delirium in the 90-day period. Thus, preoperative screening with the Montreal Cognitive Assessment tool provides a baseline cognitive assessment and early identification of patients at higher risk for postoperative delirium, and therefore, identification of patients at risk for postoperative delirium may allow for early interventions and decrease postoperative delirium....
Confronting Polypharmacy in Corrections: An Interprofessional Team Approach
Polypharmacy is a growing community problem, and is evident in correctional healthcare. Using Lewin’s Change Theory, action research, and an interprofessional team approach in this project, potentially problematic ...
A Quality Improvement Plan to Decrease Acute Care Transfers through Better Staff Communication about Status Changes Among Assisted Living Residents
Elderly residents of assisted living facilities (ALFs) are generally frail and may have multiple comorbidities (National Center for Assisted Living, 2010). Inadequate communication of changes in resident status precludes ...
Gaps in Pain Management in Assisted Living
Assisted living (AL) is a growing lifestyle choice option available to the ailing aged in the United States. Increases in chronic disease may predispose this population to acute and chronic pain due to increased longevity ...
Social Isolation In Long Term Care: Improving Assessment and Decision-Making Skills
The purpose of this project was to evaluate the effect of a quality improvement project with a multicomponent intervention on assessment and decision-making skills for healthcare professionals who are responsible for the care of elderly residents at risk for social isolation. A group of 20 healthcare professionals working in a small long term care facility participated in the project. A quasi-experimental with a pretest and posttest design was used to collect and compare scores achieved on each exam. A matched t-test statistical procedure was utilized to determine whether a quality improvement project with a multicomponent intervention had significant impact on assessment and clinical decision-making skills of healthcare professionals. Following the implementation of the quality improvement project, healthcare professionals scored significantly higher on the posttest (with a mean of 94.5%) than on the pretest (with a mean of 55.75%). The quality improvement project with a multicomponent intervention had a significant impact on assessment and clinical decision-making skills. These results concluded that healthcare professionals responsible for the care of elderly residents at risk for or currently experiencing social isolation should implement quality improvement projects as a continuous method to improve assessment and clinical decision-making skills. ...