Auswirkungen der Einführung eines Delir-Screeningverfahrens mit der Nursing-Delirium-Screening-Scale (Nu-DESC) im Aufwachraum

Schroeder, Zoé (2023): Auswirkungen der Einführung eines Delir-Screeningverfahrens mit der Nursing-Delirium-Screening-Scale (Nu-DESC) im Aufwachraum. Dissertation, LMU München: Medizinische Fakultät

Abstract

Background: Postoperative Delirium is common in the post-anesthesia caring unit (PACU). Our objective was to examine the effects of a newly introduced screening method in 2015 on the patient’s outcome and pharmaceuticals prescribed in the PACU. Method: At the end of the recovery period, delirium was assessed using the Nursing Delirium Screening Scale Nu-DESC). Electronic records before (2010-2014) and after the introduction (2015-2017) of the screening were analyzed. Differences in medication use were detected through Mann-Whitney-U-test. Results: Out of 45,266 patients, 1,031 (3.2%) developed delirium in the PACU. An increase in the administration of haloperidol (p≤0.01), clonidine (p≤0.01), lorazepam (p=0.02) and propofol (p≤0.01) was recorded after the introduction of Nu-DESC screening in contrast to midazolam (p=0.1) and dexamethasone (p=1.0), which remain unaffected. Mortality decreased from 1.0% to 0.6%. Contrary, patient´s length of stay in the PACU increased by 27 minutes (p≤0.01). Conclusion: Significant increase in the administration of clonidine, haloperidol, and lorazepam, as well as the increased time in the patient's recovery room, indicate an adjusted delirium treatment induced by the screening procedure. The decrease in hospital mortality through the implementation of screenings was previously shown by Radtke et al [1]. Further studies to optimize the therapy of delirious patients in the recovery room are needed.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: Postoperatives Delir, Nursing Delirium Screening Scale, Aufwachraum
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 5. Oktober 2023
• 1. Bericht­erstatter:in: Saller, Thomas