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Delirium Part 1: Prevalence, Pathology, Risk Factors, and Prevention

presented by Kathleen Fletcher and Heather Teller

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Financial— Kathleen Fletcher and Heather Teller receive compensation from MedBridge for the production of this course. There are no other relevant financial relationships. Nonfinancial— No relevant nonfinancial relationship exists.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 35 Minutes; Learning Assessment Time: 29 Minutes

Delirium is an acute state of confusion characterized by its sudden onset, fluctuating course, impaired attention, and disorganized thinking. It can be the first sign of acute illness. This first course in a series of three gives nurses in all settings an understanding of the prevalence and pathology of delirium. Specific risk factors will be discussed with an emphasis on preventable strategies.

Meet Your Instructors

Kathleen Fletcher, RN, DNP, GNP-BC, FAAN

Kathleen Fletcher is currently working as a PRN staff nurse at the Riverside Center for Excellence in Aging and Lifelong Health and as a Clinical Assistant Professor at the University of Virginia School of Nursing. She maintains a hands-on role, working as a clinician, educator, and researcher in gerontology for more than 35 years. She…

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Heather Teller, BSN, BA, RN, CMSRN, GRN

Heather Teller is a Virginia-based nurse educator and acute care facility staff development coordinator. For the past eight years, she has worked on the subject of delirium as part of an interdisciplinary team at Riverside Health System. During that time, she developed the nursing education program to help reduce hospital-acquired delirium and aid in the…

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Chapters & Learning Objectives

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1. Definition and Prevalence of Delirium

Licensed nurses (RN, LPN) in all settings need to understand how delirium is defined and the various forms of it. Delirium is often mistaken for dementia, and complicating the picture is the fact that they often coexist. Since delirium is often not recognized, appreciating the frequency of it will help nurses recognize its features earlier in the course and take appropriate action.

2. Pathology of Delirium

A greater understanding of the potential pathologies of delirium and the laboratory and imaging studies that may be ordered by the primary care provider will help nurses understand the cause(s) of it and report and respond quickly. This chapter focuses on the pathology of delirium. The purpose of this chapter is to help nurses glean a better understanding of the interacting biological factors that lead to acute cognitive dysfunction.

3. Risk Factors and Preventive Strategies

Evidence-based studies have defined the predisposing and precipitating factors for delirium. This chapter aims to assist nurses to identify risk factors for delirium and the appropriate preventive strategies in order to decrease the occurrence or duration of delirium.

More Courses in this Series

Delirium Part 2: Tools and Techniques for Screening and Assessment

Presented by Kathleen Fletcher, RN, DNP, GNP-BC, FAAN and Heather Teller, BSN, BA, RN, CMSRN, GRN

Delirium Part 2: Tools and Techniques for Screening and Assessment

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 29 Minutes; Learning Assessment Time: 30 Minutes

Delirium can be difficult to recognize and distinguish between other mental disorders such as dementia and depression. This second course, in a series of three on delirium, gives nurses in all settings a framework for identifying the various features of each of the 3 D’s (delirium, dementia, and depression,) and provides guidance on recognizing when the presentation may be a mixed form. Because the presentation may not be obvious, the routine use of evidence-based tools is recommended. Several of these tools will be discussed. Family members and all members of the health care team can be instrumental is observing and reporting changes in mental status to a health care professional.

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Delirium Part 3: Interventions in the Management and Treatment

Presented by Kathleen Fletcher, RN, DNP, GNP-BC, FAAN and Heather Teller, BSN, BA, RN, CMSRN, GRN

Delirium Part 3: Interventions in the Management and Treatment

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 67 Minutes; Learning Assessment Time: 36 Minutes

The broad spectrum of pathologies for delirium dictates that not all patients in rehabilitation or residents in long-term care have to be hospitalized when they demonstrate signs and symptoms of delirium. Hospitalization, in fact, can make the condition worse due to change in the environment and care providers. However, delirium can be a life-threatening event, and at times emergent care is required. This final course in the three-part series of courses on delirium will emphasize good clinical decision-making skills and the need for all nurses in all settings to have these skills. In many settings, including rehabilitation, long-term care, and outpatient care, management of delirium may be successful, provided an accurate assessment and diagnosis can be made and the interventions necessary to address the care needs in that setting can be accomplished. This course will emphasize both non-pharmacological and pharmacological interventions in the care of persons with delirium.

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Delirium: Observing and Reporting Mental Status Changes by the Nursing Assistant

Presented by Kathleen Fletcher, RN, DNP, GNP-BC, FAAN and Heather Teller, BSN, BA, RN, CMSRN, GRN

Delirium: Observing and Reporting Mental Status Changes by the Nursing Assistant

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 47 Minutes; Learning Assessment Time: 28 Minutes

Care team members including nursing assistants, patient care assistants, and rehabilitation aides assist the members of the professional staff in caring for individuals in various settings. These individuals typically spend the most time providing care for patients within facilities. Because of this, they are often in the best position to observe even subtle changes in the patients’ mental capacity, function, and behavior. This course will focus on the important role of the UAP in all settings in observing the signs and symptoms of mental status changes and thoroughly reporting these changes to the professional staff in order for the patient to be assessed for possible delirium. Delirium is an emergency and can indicate a life-threatening illness. Too frequently, it is unrecognized until the patient’s condition deteriorates. The UAP who takes the initiative to observe and report mental status changes is a valuable member of the care team.

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