Delirium diagnostic 2012 to 2021, contribution of CAM and clinical nurses of the geriatric consultation team in CIUSSS de l’Estrie‐CHUS
Guy Lacombe, Maria Bel‐Maréchal, Cathy Mc Cowan, Émilie Sabourin‐Tremblay, Véronique Poulin- Psychiatry and Mental health
- Cellular and Molecular Neuroscience
- Geriatrics and Gerontology
- Neurology (clinical)
- Developmental Neuroscience
- Health Policy
- Epidemiology
Abstract
Background
To evaluate the evolution of diagnostic of delirium following the introduction of CAM as a geriatric vital sign as part of The Specialized Approach to Senior Care (l’approche adaptée à la personne âgée, AAPA) in University Hospital CIUSSS de l’Estrie‐CHUS in 2014.
Method
Training on CAM and delirium was given in 2014. The nurses of the geriatric consultation team make recommendations/coaching to the treating teams during geriatric consultations. We analyze ICD‐10 data from > 65‐year‐olds hospitalized at the CHUS before (2012) and after (2016). A criteria base analysis of the files with diagnosis of delirium on the discharge letter or a geriatric consultation of November 2016 describes the considerations related to delirium.
Result
Of the 32,000 hospitalizations at CHUS in 2016, 13,000 are over 65 years old and 1296 have a geriatric consultation. 2.2% in 2012 to 2.7% in 2016 had delirium according to the exit letter. That is 3% of 65‐75 year olds and 8% of those over 75. 102 consecutive files of geriatric nursing consultations from November 2016 are reviewed. 63 new diagnoses of delirium with an average of 3 recommendations from the AAPA to the treatment team.
Conclusion
Delirium remains under‐documented at release and improves little from 2012 to 2021. The modalities of use of the current tools remain insensitive. The support of geriatric consultation teams remains necessary to support the development of AAPA against delirium.